Guidance on treatment decisions

The need: from whence will my help come?
When you or your loved ones are facing life-limiting illness, deciding about medical treatment can be excruciating. There is so much that medical science can do, but we need discernment in making these wrenching choices. Are the burdens of a given treatment worth its benefits? Is it time to fight for life at any cost, or is it time to allow death to come? Too often, the busy context of medical care offers little help.

What I bring
As a chaplain, I have accompanied thousands of elders and their families through the complex world of medical treatment. As co-founder of a medical ethics committee and as a consultant, I have helped healthcare organizations develop educational and policy resources that foster clarity and values-driven healthcare ethics.

How I can help
I will work with you or your family to sort through the complex information and emotions you face as you approach medical treatment decisions. I can help you cut through the confusion to sort out what is most important to you now, and to make choices that align with your goals and values. I will work with you around a specific decision crux, or over the course of time.

To explore working together, please contact me.

A story about my family’s struggle: “There is always more we can do”

Years ago, my family’s matriarch, Grammy Anne, lay in intensive  care. The family was shocked and confused. Just last year this dignified, spunky 86 year-old had been taking college courses. Now,  she was connected to tubes from every orifice, delirious and barely speaking; she had “crashed” after surgery successfully repaired an  intestinal blockage.

A wise pulmonologist told us, “You all need to decide what you are  trying to achieve here, because there is pretty much always something  more we doctors can do, and that is not necessarily what your family  member wants.”

We discussed what Grammy Anne would have wanted. We agreed that she would not want to live like this. We decided that we would  not authorize any life-extending treatment if she did not improve. She did not. Her attending physician apparently did not understand us—he inserted a feeding tube—in direct contradiction to our wishes. Grammy  spent the next four months in a nursing home, never once having a  moment of calm or pleasure. We all felt terrible about her suffering, and outraged that her wishes were not respected.

In the years since this sad episode, I have learned much about  medical treatment and decision-making. I wished that my family had help  to advocate for Grammy Anne’s values and choices. I have learned that weighing burdens and benefits of treatment is a very individual matter, but one that belongs to the patient and family.  I have accompanied thousands of elders and their families and helped  them to make decisions based on their unique values and goals. And I  have advocated, both systemically and individually, to ensure that  their choices were respected.

If your family would like help clarifying a dilemma around treatment decisions, feel free to contact me.

 

My Grammy Annie, age 75,having a blast on a cruise. See a story on dilemmas at the end of her life here

Click here to read an essay I wrote about end of life treatment decision-making.