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Who should discuss end-of-life options?

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This article in The New England Journal of Medicine reviews 40 years of policies regarding end-of-life decisions.

And here’s a discussion of a  cancer patient’s issues regarding final treatment options and advanced directives.

The article addresses:

”Who should have the difficult discussion of the goals of care with Anne {the patient}? With whom does this responsibility lie? What course of action should you take?

Here are three options:

”1. As the primary care physician, discuss the goals of care with the patient yourself.

”2. Recommend that the oncology team discuss the goals of care with the patient.

”3. Refer the patient to a palliative care physician who will discuss the goals of care with the patient.”

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