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Getting Your Clients Past Magical Thinking
Today’s post is very personal, reflecting a situation I believe many families go through, brought on by any number of attitudes and fears. I’m hoping that by sharing it, you can find a role for your advocacy work. It’s about providing a gift to some of your patients and their families – in effect, giving them permission to say no to further treatment. As I thought about the situation, I remembered back to a blog post I had written almost four years ago called “When Is It Time to Just Say NO to Further Treatment?” When I wrote it, I was referring to my mother who at the time was in her 10th year of her Alzheimer’s diagnosis and had little or no cognition left, yet my father kept insisting she be treated for every urinary tract infection (UTI) she acquired (or, perhaps more like, never really got rid of.) It made no sense to me, yet Dad was just so desperate to keep Mom alive. My post was based on this article from the New York Times: In Cancer Therapy, There Is a Time to Treat and a Time to Let Go which talks about patients desperately insisting on treatment, even though it not only won’t prolong their lives, but will actually cause them more distress. In effect, helping them get past (what many experts call) Magical Thinking. The question is: Who suggests to the patient and family that a treatment isn’t magical? Who helps them get past wishful thinking and into reality? Who says to a cancer patient, “Chemo is toxic, and while you might get an extra week or two on this earth, you’ll be sicker for that time – your quality of life cannot be improved. Are you sure you still want to put yourself through that?” ??? To me, this is an ethical question. It’s information that is owed to patients. Yet no one is offering that information. No – doctors rarely confront their magical thinking patients. Why? Two reasons: it takes too long (there is no reimbursement for time), and doctors often have a…