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A physician’s guide to talking about end-of-life care

Journal of General Internal Medicine volume 15, pages 195–200 (2000)Cite this article

Abstract

A large majority of patients and close family members are interested in discussing end-of-life issues with their physician. Most expect their physician to initiate such dialogue. End-of-life discussions, however, must go beyond the narrow focus of resuscitation. Instead, such discussions should address the broad array of concerns shared by most dying patients and families: fears about dying, understanding prognosis, achieving important end-of-life goals, and attending to physical needs. Good communication can facilitate the development of a comprehensive treatment plan that is medically sound and concordant with the patient’s wishes and values. This paper presents a practical 4-step approach to conducting end-of-life discussions with patients and their families: (1) Initiating Discussion, (2) Clarifying Prognosis, (3) Identifying End-of-Life Goals, and (4) Developing a Treatment Plan. By following these 4 steps, communication can be enhanced, fears allayed, pain and suffering minimized, and most end-of-life issues resolved comfortably, without conflict.

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Affiliations

  1. the Cambridge Health Alliance, Cambridge, Mass

    Richard B. Balaban MD

  2. Harvard Medical School, Boston, Mass

    Richard B. Balaban MD

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  1. Richard B. Balaban MD
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Correspondence to Richard B. Balaban MD.

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Balaban, R.B. A physician’s guide to talking about end-of-life care. J GEN INTERN MED 15, 195–200 (2000). https://doi.org/10.1046/j.1525-1497.2000.07228.x

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  • DOI: https://doi.org/10.1046/j.1525-1497.2000.07228.x

Key words

  • advance directives
  • communication barriers
  • decision making
  • end-of-life care
  • patient-doctor communication