Modules:

More About:

Back to Module 7: Goals of Care Goals of Care

7-Step Protocol to Negotiate Goals of Care
Identifying Goals to Hope For
Cultural Considerations
Communicating Prognosis
Use of Language

• Language with Unintended Consequences
• Language to Describe Goals of Care

Setting Goals and Priorities for Treatment and Care
Decision-Making Capacity

Use of Language

Language With Unintended Consequences

• Well-intentioned physicians may say things that will have unintended consequences

• What the listeners understand may be quite different from what the physician intended

• Some examples of questions that can have unintended consequences include:

• Do you want us to do everything possible?


• Will you agree to discontinue care?


• We’ll refrain from extraordinary measures?


• It’s time we talk about pulling back?


• I think we should stop aggressive therapy


• I’m going to make it so he won’t suffer

• The unintended message of these statements may easily be that the patient and family expect imminent abandonment and see only a stark choice between aggressive curative intent and giving up

^top

Language to Describe Goals of Care

• In order to prevent unintended consequences, it is useful to develop facility with language that reinforces the goals of appropriate medical care for someone with advanced progressive illness and a life-threatening prognosis

• Some examples include:

• I want to give the best care possible until the day your child dies


• We will concentrate on improving the quality of your life


• We want to help you live meaningfully in the time that you have


• I’ll do everything I can to help you maintain your independence


• I want to ensure that your father receives the kind of treatment he wants


• Your child’s comfort and dignity will be my top priority


• I will focus my efforts on treating your child’s symptoms


• Let’s discuss what we can do to fulfill your wish to stay at home

^top

>continue