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Certain treatments can help sustain life when you have a serious illness. But as your illness progresses, there may come a time when these treatments are no longer a benefit. Decisions must then be made whether to continue or stop these treatments. This can be a hard task for you and your loved ones, but know that you’re not alone. Your doctor and healthcare team will guide you through these treatment decisions. They will also help answer any questions you may have.
Life-sustaining treatments help keep you alive if a vital body function fails. These treatments can include CPR and the use of machines to assist with heart, lung, or kidney function. They can also include the use of tubes to deliver food, fluids, and medications to the body. Blood transfusions, blood products, and antibiotics are also types of life-sustaining treatments.
These treatments can help extend your life. However, they will not cure your illness. If you are near the end of your life, you may find it hard to tolerate the side effects and problems that can occur with these treatments. In this case, the treatments may be too much of a burden on your body and may cause more harm than good. They may also disrupt the natural dying process and prolong suffering.
If these treatments are stopped, the focus of treatment will shift to comfort care. This involves measures to control pain and other symptoms you may have. These measures are not meant to cure your illness or help you live longer. Instead, they are meant to improve your quality of life during the time you have left. If you are in the end stage of your illness, you may be referred to hospice by your doctor. Hospice provides end-of-life care. This includes emotional, spiritual, and social support for you and your loved ones.
Your doctor and healthcare team will talk with you about the specific treatments that are part of your care plan. If you want, you may include family and friends in these meetings. Here are some questions to think about or ask your healthcare team:
Is there is a chance that my illness will improve? Or will it continue to worsen?
What are my goals of care? Do I want to extend the time I have left? Or do I want to focus my care on comfort and managing symptoms?
How will stopping or continuing these treatments affect my health? Will they enhance my comfort and quality of life? Or will they cause further problems?
Consider your own values or faith. Also ask for advice from those who share your values.
Once you’ve made your decision to continue or stop specific treatments, you can tell your doctor directly. It is best to also put your treatment wishes in writing with advance directives. These are legal forms related to healthcare decisions. Laws about advance directives vary from state to state. Ask your doctor about what forms are needed to make sure your wishes will be followed. Some common forms include:
A durable power of attorney for healthcare or healthcare proxy form. This form allows you to name a person to make treatment decisions on your behalf when you can’t. This person is often called a healthcare proxy, medical or healthcare power of attorney, or agent.
A living will. This form tells others the kinds of treatment you want or don’t want if you become too ill or injured to speak for yourself.
Keep in mind that you can change or cancel an advance directive at any time. Make it a practice to review your decisions each time there is a change in your health or goals of care. Also be sure to tell your healthcare proxy and loved ones of any changes in your decisions.
Ideally, the decision to stop treatment is made with the patient’s consent. But in some cases, the decision falls to the patient’s healthcare proxy or other adult. If you need to make a decision about stopping treatment for a loved one, start by talking to his or her doctor. Review the goals of care and the benefits and burdens of specific treatments on your loved one’s health. Also think about your loved ones wishes and values. If needed, seek advice from other healthcare team members, such as a social worker or spiritual advisor.