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Discussing Treatment Preferences With Patients Who Want "Everything"
Annals of Internal Medicine, 09/01/09

Quill TE et al. – Asking patients and families to explore the underlying emotions, concerns, and values that prompt their requests for "everything" is a powerful way to inform the health care team about a patient's treatment philosophy. This exploration provides information on the relative value that patients place on extending life versus avoiding suffering in light of their medical condition. Physicians can use this information to make recommendations about invasive treatments. Many times, limits can be set after this conversation, but CPR and other invasive treatments are sometimes desired no matter how small the benefits and how high the burdens. In these cases, patient preferences should generally be honored, but clinical judgment must still be exercised to maximize benefit and minimize harm.

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