Letters to the Editor
Approaching the Conversation of End-of-Life Treatment Options
Am Fam Physician. 2008 Sep 1;78(5):562-564.
Original Article: End-of-Life Care: Guidelines for Patient-Centered Communication
Issue Date: January 15, 2008
Available at: http://www.aafp.org/afp/2008/0115/p167.html
to the editor: The article on end-of-life care provided a number of useful practice suggestions for communicating effectively and compassionately with patients and their families who are dealing with the difficult issues that accompany terminal illness. The authors appropriately identified the frequently asked question, “Do you want us to do everything that we can to keep you alive (e.g., artificial life support)?”, as one which often leads patients and families to conclude that choosing anything other than all available care means not obtaining the best available care. Framing questions in this fashion, without providing appropriate medical context, leaves patients and families at a tremendous disadvantage to discern what alternatives and approaches might be available to them to obtain the most effective end-of-life care.
An alternative approach would be to initiate this type of conversation by posting a positive framework: “In the event you become extremely ill, I would suggest we use treatments that offer a real chance at meaningful recovery, and not embark on treatments that do not offer a real opportunity to provide you a meaningful benefit. Would you like to talk about the types of therapies that might fall into each category?” This approach has been effective in helping patients and their families cope with the difficult situation of terminal illness care in a way that is collaborative and appropriately shares decision-making among patient, family, and physician.
Author disclosure: Nothing to disclose.
Send letters to Kenneth W. Lin, MD, MPH, Associate Deputy Editor for AFP Online, e-mail: email@example.com, or 11400 Tomahawk Creek Pkwy., Leawood, KS 66211-2680.
Please include your complete address, e-mail address, and telephone number. Letters should be fewer than 400 words and limited to six references, one table or figure, and three authors.
Letters submitted for publication in AFP must not be submitted to any other publication. Possible conflicts of interest must be disclosed at time of submission. Submission of a letter will be construed as granting the American Academy of Family Physicians permission to publish the letter in any of its publications in any form. The editors may edit letters to meet style and space requirements.
Copyright © 2008 by the American Academy of Family Physicians.
This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Contact firstname.lastname@example.org for copyright questions and/or permission requests.
Want to use this article elsewhere? Get Permissions