"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.

"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.

"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.

"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.

Presenter:  Rochelle Maurice, Clinical Ethicist, Centre for Clinical Ethics

"Can self-advocacy go overboard?  Examining the ethical issues at the intersection of patient self-advocacy and standard clinical practice"

Patients are empowered to be advocates for themselves as they partner with healthcare teams to address their clinical concerns. This gives patients the ability to control their treatment based on their personal needs and values. It also affects the relationship between patients and healthcare teams. This presentation will explore the ways in which patient self-advocacy influences the development and operationalization of treatment plans.

 Objectives:

- to examine the intended and unintended consequences of patient self-advocacy
- to explore scenarios where patient self-advocacy leads to requests for treatment that are on the margins of standard clinical practice
- to discuss the ethical tensions that arise when patient self-advocacy leads to conflict between the patient and the healthcare team​

Presenter:  Rochelle Maurice, Clinical Ethicist, Centre for Clinical Ethics

"Can self-advocacy go overboard?  Examining the ethical issues at the intersection of patient self-advocacy and standard clinical practice"

Patients are empowered to be advocates for themselves as they partner with healthcare teams to address their clinical concerns. This gives patients the ability to control their treatment based on their personal needs and values. It also affects the relationship between patients and healthcare teams. This presentation will explore the ways in which patient self-advocacy influences the development and operationalization of treatment plans.

 Objectives:

- to examine the intended and unintended consequences of patient self-advocacy
- to explore scenarios where patient self-advocacy leads to requests for treatment that are on the margins of standard clinical practice
- to discuss the ethical tensions that arise when patient self-advocacy leads to conflict between the patient and the healthcare team​

Presenter:  Rochelle Maurice, Clinical Ethicist, Centre for Clinical Ethics

"Can self-advocacy go overboard?  Examining the ethical issues at the intersection of patient self-advocacy and standard clinical practice"

Patients are empowered to be advocates for themselves as they partner with healthcare teams to address their clinical concerns. This gives patients the ability to control their treatment based on their personal needs and values. It also affects the relationship between patients and healthcare teams. This presentation will explore the ways in which patient self-advocacy influences the development and operationalization of treatment plans.

 Objectives:

- to examine the intended and unintended consequences of patient self-advocacy
- to explore scenarios where patient self-advocacy leads to requests for treatment that are on the margins of standard clinical practice
- to discuss the ethical tensions that arise when patient self-advocacy leads to conflict between the patient and the healthcare team​

Presenter:  Rochelle Maurice, Clinical Ethicist, Centre for Clinical Ethics

"Can self-advocacy go overboard?  Examining the ethical issues at the intersection of patient self-advocacy and standard clinical practice"

Patients are empowered to be advocates for themselves as they partner with healthcare teams to address their clinical concerns. This gives patients the ability to control their treatment based on their personal needs and values. It also affects the relationship between patients and healthcare teams. This presentation will explore the ways in which patient self-advocacy influences the development and operationalization of treatment plans.

 Objectives:

- to examine the intended and unintended consequences of patient self-advocacy
- to explore scenarios where patient self-advocacy leads to requests for treatment that are on the margins of standard clinical practice
- to discuss the ethical tensions that arise when patient self-advocacy leads to conflict between the patient and the healthcare team​

Presenter:  Jeremy Butler, Clinical and Organizational Ethics Fellow, Centre for Clinical Ethics Presentation Title:  Responding to Requests for Futile and non-Beficial Treatment Patients, families, and substitute decision-makers often request treatments that healthcare providers think are non-beneficial or inappropriate in the circumstances. Sometimes clinicians believe the requested treatments to be futile, […]

Presenter:  Jeremy Butler, Clinical and Organizational Ethics Fellow, Centre for Clinical Ethics Presentation Title:  Responding to Requests for Futile and non-Beficial Treatment Patients, families, and substitute decision-makers often request treatments that healthcare providers think are non-beneficial or inappropriate in the circumstances. Sometimes clinicians believe the requested treatments to be futile, […]