Why should I talk to my doctor about my end-of-life wishes?

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David R. Grube, MD
Family Medicine
It's important to talk to your doctor about your end-of-life wishes and complete an advance directive, so that the proper end-of-life care is administered to you. Watch family medicine specialist David Grube, MD, discuss why this conversation is key. 
Your doctor may help you understand you health so that you may make more informed decisions about your healthcare choices in the future. And, speaking with your doctor makes it more likely that your wishes will be known and respected. Evidence suggests that physicians are not as engaged as many patients may believe. The U.S. Agency for Healthcare Research and Quality, in a 2003 article, “Advance Care Planning: Preferences for Care at the End of Life,” found the following:
  • Less than 50% of the severely or terminally ill patients studied had an advance directive in their medical record.
  • Only 12% of patients with an advance directive had received input from their physician in its development.
  • Between 65% and 76% of physicians whose patients had an advance directive were not aware that it existed.
Katie Ortlip
Hospice Nursing

It has been well established that the more we discuss our end-of-life wishes, the more likely they are to come true! Having this talk with your doctor with family members present is a good first step to planning for this often difficult time. The next step is to document your wishes in a living will/advanced directive and have the doctor fill out a DNR (Do Not Resuscitate) order, if you do not want this process started when your heart and breathing stop. Having your doctor present gives you the chance to ask questions about what certain procedures and life-sustaining treatments involve and how they may impact on your quality of life. I find that discussing your wishes with your doctor and making CLEAR what they are, reduces fear and anxiety for the person and their families. It is truly a gift to your loved-ones, relieving them of having to make sometimes agonizing decisions on your behalf. It also frees you up to enjoy more fully the time you have left, whether it's months or years.

 

Barbara Coombs Lee
Hospice Nursing
One important study evaluated the quality of life at the end of life for people with advanced cancer. Lo and behold, those individuals who had discussed end-of-life values and preferences with their doctors experienced significantly less suffering in their final week of life. A significant reduction in intensive care hospitalizations and high-technology interventions accounted for this desirable outcome. Not too surprising, the patients who had talked with their doctors and who experienced a more peaceful, pain-free end of life also received less costly care than those tethered to the tubes and machines meant to extend their lives.

But one finding is stunning enough to be a game changer in end-of-life care. For all the suffering they inflicted and all the cost they incurred, the tubes and machines actually bought no life extension. None.

It’s hard to imagine a worse situation for a person dying of cancer -- trapped in an intensive care unit, remote from family and loved ones, suffering through intrusive and painful medical procedures and living no longer than those who chose to end their lives in hospice, at home, with loved ones at their side.

Continue Learning about End Of Life Issues

Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.