Initiating end-of-life care discussions

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9 Oct 2016 - General

End-of-life-care conversations are difficult to initiate. Some patients may misunderstand the intention of healthcare practitioners if they initiate this conversation once the patient is diagnosed with a terminal illness. What usually happens is, these conversations are initiated once the patient enters the advanced stages of the disease, or worse advanced directives are only sought once patient goes into cardiac arrest. In the United States, initiatives are being done to educate children regarding advanced directives and by the time that they reach 18, they can formalize their preferences for end of life care. I think this should be adapted in our local setting because this makes end of life care more efficient. I've witnessed countless times that families have disagreements over end of life care decisions for brain dead patients. This often leads to prolonged hospitalization, confusion in goals of treatment and unnecessary medical expenses.

Do you think end-of-life care discussions should be initiated earlier on? If so, when do you think it is it appropriate to discuss this issue with patients?

I agree, this should be done early. End-of-life care discussions are almost always avoided by families and patients until the patient becomes too sick to even decide on the matter. Even doctors are uncomfortable discussing it early on. Sometimes, relatives do not respect advance directives by patients because they claim that they are not aware when such decisions were made and that the patient may have been misinformed or just "depressed". Especially for us Filipinos who are culturall...
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In my opinion Dc. Marinelle Castro, yes. It is better to present the recent status of the patient (both, positive and negative). So that the significant others can decide whether to cintinue tge treatment or not. But we can't blame them for prolonging their stay in the hospital cause in some cases, the family tend to do this where the patient stay longer in the hospital primarily because they are waiting for ...
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