People need to openly discuss
their end-of-life care beliefs and choices with their
families and doctors, says Dr. James Tulsky, director
of the Center for Palliative Care at Duke University
"There are two settings in which you may want to
consider end-of-life decisions: in the context of
serious illness, and as a healthy person looking ahead.
In either case, one needs to consider what he or she
personally values in life and communicate that to
people you love through conversation and perhaps also
in writing," Tulsky said in a prepared statement.
He said patients who are seriously ill and their
family members need to ask questions of doctors and
other health-care providers to get all the information
needed to make appropriate decisions.
"It's important to ask your doctor 'what if' questions.
For example, 'What if the surgery is unsuccessful?
What is my option then?' People sometimes have difficulty
discussing such issues because it is hard for them
to consider that the treatment might not work. They
may worry that a failure to remain positive could
actually have an adverse effect on their outcome,"
He recommended that people hope for the best while
planning for the worst.
"Patients should think through with their health-care
provider what to do if a treatment doesn't go well
and be willing to engage that. It doesn't mean that
you are giving up; it just means you are considering
all of your options so that you can make the best
decision regardless of what you find," Tulsky said.
"Families should also ask physicians what they recommend.
This is not, 'What would you do for your mother?'
but rather, 'What should we do given what you understand
about our mother.' Physicians should provide recommendations
that reflect the patient's core values," he added.
Reference Source 101