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Goals of Care

About this resource
Author: Waterloo-Wellington Regional Cancer Program
Revised: March 2011
PEM: 6108

Discussing and making decisions about emergency and life-sustaining treatments can be hard but is important. Please don’t be surprised when we ask you about this. Your healthcare team wants to help you and your family. When they know your wishes, we can help guide your health care.

Discussing your choices…

An example of a medical emergency

A medical emergency may happen when your heart beat or breathing becomes irregular, or your heart stops beating.

After an emergency like this happens, an emergency team responds to restore your heart and breathing using cardiopulmonary resuscitation (CPR).

What is CPR?

CPR can include:

  • Pushing very firmly on your chest, injecting medications and sometimes administering electric shocks through your chest to restore your heartbeat, and/or
  • Inserting a tube into your lungs and connecting that tube to a breathing machine (also called a ventilator) to breathe for you.

What do you want your health team to do in an emergency situation, for example, if your heart stops beating? It’s important to think about the risks and benefits of emergency care such as CPR before making a decision.

You have the option of choosing all, none or only some of the treatments offered, depending on your medical condition.

How effective is CPR?

The benefits and risks are very different and vary between patients. Your doctor will be able to tell you if CPR would be a good choice for you based on your current health and medical conditions. Factors affecting the outcome of CPR include your diagnosis, age, severity of illness, and conditions that may influence your heart and breathing to stop.

It’s your right to have your wishes respected. We can’t assume our usual practice will be what you want. Making a decision about emergency situations will not affect your options for other medical treatments.

How can you prepare?

  • Reflect on your own values and feelings about death and end-of-life care;
  • Talk with your family and get their support. Let them know your choices;
  • Record your care wishes. Include a “do not resuscitate” directive if that’s what you want. Have the documentation available when you’re admitted. Please make sure you include any record about a substitute decision maker (SDM); and
  • Ask questions and be involved.

When do you have to decide?

When you’re in the hospital, we will ask about your wishes and discuss options for emergency and life-sustaining treatments. You may ask for more information and talk about your options with family and friends.

When you inform your health care team of your wishes, it will help guide your care if you’re unable to speak for yourself.

Can I change my mind?

Yes. If you change your mind, please tell someone on your health care team. They will document your new wishes and ask your doctor to discuss them with you.

Remember: you’re not alone. You can talk about your wishes and feelings with your care team, family, friends or your SDM. They’ll support and help you with your decision.

Talk to your healthcare team

Your doctor will meet with you to talk about your plan of care, treatment options, and choices in the event of a medical emergency. A member of your health care team can also explain what would normally happen if a medical emergency occurs. Your healthcare team wants to help you understand all possible issues. Please ask questions and share your wishes regarding your care in the event of an emergency or at the end of life.

We also encourage you to speak with your family and friends for their support.

If you’d like to talk about care choices or have any questions about this information, we’re here to help. Please speak with anyone on your health care team such as a nurse, social worker or a spiritual care provider.

Just ask a member of your health care team if you wish to contact WRHN’s ethics committee.

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Use this resource for your information only. It does not replace medical advice from your doctor or other healthcare professionals.

Email: [email protected]

Website: www.cancerwaterloowellington.ca