Discussions

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