Developing a Plan: Options

In discussing available options sometimes patients, families, and even clinicians forget that care options, doing this or that, are only a way to get to particular goals. When arguments arise about what to do, sometimes people are really disagreeing as to what is the best goal to pursue. At other times, people may disagree as to whether a particular care option will actually get the patient to a mutually desired goal. It may help to compare notes on where the disagreement lies.

What you can do:
(If disagreement arises as to what is best to do)

  • Even if you disagree strongly, most people truly want the best for your loved-one. While it is fine to express your opinion, try to respectfully listen to the other’s opinion.
  • If you find yourself arguing over a particular therapy or approach with someone, avoid statements that characterize your preference simply as “good” and theirs, as “bad.” Rather, you might ask the other person (and yourself) a couple of basic questions:
    • "What is your understanding of what is going on with [your loved-one]?" It may be that the other person has a very different understanding of how well your loved-one is doing medically. If so, you may be disagreeing not so much on where you are going, as to where you are.
    • "What is it you hope the course of care you recommend or desire will accomplish?" A question like this may help you understand both the other person’s goal(s), but also how they see the option helping get to the goal. You may find that you agree on the goal, but disagree on whether a particular care option will be helpful in reaching that goal. Or, you may find that there is a more basic disagreement about what goal is appropriate.
    • “Is there any additional information that might be useful in resolving the disagreement?” Sometimes people make assumptions about what is appropriate or inappropriate care. These assumptions usually reflect deeply held beliefs or values that should be respected. However, sometimes assumptions may be based on a misunderstanding of what is being proposed. Getting an outside opinion may help resolve the conflict.


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