Your Values, Your Voice
Making Decisions in Cases of Serious Illness
A collaborative approach to medicine between practitioner and patient has not always been standard practice, let alone even possible. In their landmark “Awareness of Dying” research, Glaser and Strauss (1965) described the common philosophy of “closed awareness context,” meaning that details about a patient’s diagnosis, treatment plan, and imminent death were frequently withheld. Instead, physicians minimized the seriousness of many conditions and avoided conveying actual results of tests or procedures. Unsurprisingly, there were numerous negative consequences including increased confusion, feelings of neglect and disconnect, and the inability to live one’s final days with a sense of meaning or closure.
Thankfully, this paradigm has been steadily shifting toward honesty and person-centered care.
As patients, how do we ensure that our care will be personalized? And that our wishes will be honored? We need to have conversations with care providers early and often, especially at points when our health status shifts. We need to ask questions, gather information, weigh risks and benefits, and consider pros and cons so that our choices reflect our personal values as discovered through the process of informed consent.
A Contemplation to Consider:
Imagine your best day possible. What does it include? And, who? What makes it so special and meaningful? What might this tell you about your priorities and values?
A value is a:
Examples of values include beliefs about hard work, punctuality, courtesy, independence, making good on promises, peacefulness, or being truthful. Some we hold for a lifetime and others shift as we evolve. Values guide our behaviors and choices. They inform the decisions we make for ourselves. Take time to consider and explore your personal values, and then begin completing/updating your advance care plans.
Remember: Your values, your voice, and your viewpoints matter.
Glaser, B. G., & Strauss, A. L. (1965). Awareness of dying. Chicago, IL: Aldine Publishing.