"Just give them everything!" Understanding Why Patients and Families Might Want Aggressive Medical Management Despite a Poor Prognosis

Presenter:  Sean Hillman, PhD, Clinical Ethicist, Centre for Clinical Ethics (Lakeridge Health)

Healthcare providers regularly have to deliver bad news in the form of a terminal diagnosis, or a poor prognosis, to a patient and/or their family. Quite often, there comes a fork in the road in choosing between continuing active medical management or pursuing comfort measures, and the clinical recommendation is towards palliation. Despite this, in many of these cases patients and/or families not only opt to continue a curative route, but are upset by the mere mention of anything other than aggressive interventions. But where are they coming from? How can healthcare providers cope with these challenging cases, and best help patients and families navigate such difficult decision-making?

Learning Objectives:
(1) To explore some of the possible causes for patients and families to want everything medically available, contrary to strong clinical recommendations otherwise.
(2) To empathize with and reduce stigma towards such patients and families.
(3) To provide practical strategies and legislative guidance for healthcare teams to cope with such cases, and in assisting such patients and families in their decision making.