DECISION-MAKING PEARLS
48 NB: These Reference Cards do not replace careful clinical judgment specific to each patient / family situation. PCIC: Palliative Care Interdisciplinary Curriculum is a collaborative effort of OhioHealth, The Ohio State University Wexner Medical Center, and Nationwide Children’s Hospital in Columbus, Ohio, USA, and other contributors. Permission to reproduce any or all of these PCIC Reference Cards is granted for non-commercial educational purposes only, provided that the attribution statement and copyright are displayed. To reproduce for all other purposes, contact Frank D. Ferris at info@pallmed.us. Copyright © Frank D Ferris 2013-2024. All rights reserved. V14.1, 2024 Adapted from S.P.I.K.E.S. Baile WE, Buckman R, Lenzi R et al. Oncologist 2000. PMID 10964998. And from www.VitalTalk.com. Used with permission. AUTONOMY GUIDES DECISION-MAKING Patients have the right to choose to receive or decline to receive any investigation or treatment, if they have capacity and their decision is voluntary and without coercion. If they do not wish to make decisions, they can designate someone to make decisions on their behalf. ASSESS CAPACITY ROUTINELY • Acknowledge medical situation and likely consequences of treatment options • Demonstrate a rational process to thinking about the information provided • Compare treatment options and consequences • Clearly communicate a preferred treatment choice, and why. When patients don’t have capacity, follow local laws and ethical principles guiding decision-making in their community. PATIENT- VS. FAMILY-CENTERED DECISION-MAKING Patients often prefer to make decisions in collaboration with close family members and/or their healthcare professionals. What’s best for the family may take precedence over what’s best for the patient. Understand how each patient/family typically makes decisions‒this may be rooted in cultural and/or religious norms. Use a professional translator whenever necessary. A patient with capacity to be a decision-maker is able to: • Understand the information communicated by the doctor
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