Doctors can’t read minds

By Dr Ella Johnson

Advanced Care Planning refers to making a plan for your future healthcare. It involves thinking about your values and preferences and deciding which medical treatments you would or would not want to receive. 

It becomes more important for those who are older or living with life limiting illness, however, can be completed by anyone with decision making capacity over the age of 18. These preferences can be documented in an Advanced Care Directive (ACD), which is a legally binding document in Tasmania that provides instruction to healthcare professionals about your wishes for treatment in the event you become unwell and are unable to communicate your preferences. 

As a doctor working in Palliative Care, I’ve seen firsthand how beneficial conversations about values, preferences and wishes for medical treatment towards the end of life can be. I’ve also seen how difficult it can be for family members to make decisions for their unwell loved ones when they haven’t had these discussions. Their grief is compounded by worries about what medical treatments to choose and trying to guess what their loved one would have wanted. Family members can’t read minds either. This is why advanced care planning is so important. 

To complete an ACD, you need to download the form from the Tasmanian Government Department of Health website. The form has two sections to complete; “My Values and Preferences” and “Medical Treatment I Refuse”. The usefulness of the document depends on how much detail you give in response to the questions. To ensure your ACD is thorough I would recommend talking to your GP or calling the National Advance Care Planning Support Service (1300 208 582). 

Your GP can guide you as to what medical scenarios may be relevant to you or give some examples for you to ponder. These situations will depend on your current health and what is most important to you. For example if you are young, fit and healthy you may write that there is no medical treatment you would refuse, or you may state that in the event you were unable to feed yourself or communicate to your loved ones you would not want further life sustaining treatment. Conversely, if you are an elderly person living with an incurable disease, you may decide you don’t want any life prolonging treatment, only comfort care, and you want to be allowed to die naturally. These situations and more can all be documented in an ACD. 

The process is incredibly worthwhile not only for the guidance it provides healthcare staff but also the conversations it can start with loved ones or carers about what makes life worth living for you. This can foster deeper relationships and enable you to focus your time and energy on what really matters most to you. If you are a relative or friend of someone who is elderly or living with chronic disease or a life limiting illness you may need to be proactive in finding out their wishes. Talking about sickness and dying can be awkward or uncomfortable but this temporary discomfort could bring you closer, relieve worries and save you a world of heartache in the future. After all, we’re all dying, some just more quickly than others. And doctors can’t read minds. For more information go to www.advancecareplanning.org.au