Death is the last step in the process of disease or ageing. Can we be both a source of truth and hope for our patients when death is approaching? Families want us to take the initiative for advanced care planning and parents “prioritise regular and sensitive conversations over written advanced directives” (Lotz et al, 2016, p.6). This is good bioethical practice aimed at alleviating suffering and preventing a prolonged death.
We might hesitate to explicitly discuss future health care decisions because the future is uncertain or we wish to maintain hope. Let’s face it, hypothetical discussions are difficult for physicians and families. But we must offer to plan for the best ending to each person’s story.
Balaban’s (2000) 4-step approach to advanced care planning is recommended and summarised in this resource.
Find the right words in the examples of other physicians and aspire to fearless healing.
Here are some resources to have a look at:
- The Royal Children’s Hospital (Melbourne) Bioethics Centre has a publication “Caring Decisions” for parents and families facing end of life decisions.
- The International Children’s Palliative Care Network has a list of resources and courses available for clinicians.
- The Initiative for Pediatric Palliative Care is a North American based organisation with a freely accessible curriculum for clinicians.
- Starship Child Health (NZ) also has a set of “Clinical Guidelines for End-Of-Life Care” – a very practical A-Z about day-to-day issues encountered in end-of-life care.
Credits to Dr Sherina Mubiru for this post!
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