Discussions

The title of this booklet is Discussions because there is a real need to have someof these discussions when you are a complex or chronically ill patient. These needto take place between the patient and physician, the patient and family, and thepatient and caregivers. It is not enough to say that those close to you understandwhat you would want in certain situations. It is amazing, although the subjects arediffi cult, that people handicap and burden others to make decisions about healthcare while never talking about these diffi cult topics. Some people feel that if theyare discussed, then they will occur, much as people ignore talking about death, notwishing to tempt it into occurring. Presented in this pamphlet are very diffi cult butvery important subjects that should be discussed more than once, and many shouldbe ongoing discussions with caregivers and physicians. Many patients feel that ifthese discussions are so important, the doctor should bring them up and begin thetalk. However, physicians are not trained to begin these discussions any more thanpatients are trained to do so, and the lack of communication on so vital a subject astypes of treatment choices or feeding tubes can become critical decisions for othersto make in chronically ill patients.