"The end-of-life discussion is partly avoided by physicians because it's an acknowledgment of the limits of medicine," Ben Rich, UC Davis professor emeritus of internal medicine and bioethics, told The Sacramento Bee for a recent article about the difficulty of end-of-life planning. "There's an understandable reluctance to have that kind of conversation and defer it until you don't have any other options. It's much easier to talk about the things you can do [such as treatments]."
But while the topic may be much harder to bring up, patients do have options for handling their final days, including palliative care, hospice and even forms of physician-assisted death in some states. The alternative to talking about how these choices fit into patients' goals, according to experts, too often leads to missed opportunities to give patients what matters to them most at the end of life.
As physicians are increasingly encouraged, if not required, to engage in end-of-life talks with their patients, tools and resources to help facilitate these conversations are beginning to emerge, according to the newspaper.
For example, physicians can receive free counseling about discussing end-of-life options with patients by calling Doc2Doc, a toll-free line sponsored by Compassion & Choices, a Denver-based nonprofit group that supports end-of-life planning. David Grube, M.D., and a colleague answer calls from around the country, including states where it's legal to prescribe medications to hasten a terminally ill patient's death.
Another resource is the Conversation Project, a website co-founded in 2010 by author and former Boston Globe columnist Ellen Goodman after an unsettling experience with her mother's death. A questionnaire on the website solicits feedback about what's important to patients at the end of life, such as being able to say goodbye to loved ones, and helps individuals determine where, when and how to have discussions about these wishes with family members.
Finally, families can now purchase specialized playing cards created to facilitate end-of-life thinking and conversations. The cards, which may be played with a group or by an individual, are ranked according to their personal importance, such as "have a nurse I feel comfortable with" or "take care of unfinished business with family and friends," the Bee reported.
To learn more:
- read the article