Ideally, the person who is ill will make the choices about treatments. When this is not possible, a family member or person chosen as substitute decision-maker may be asked these choices. It can be very difficult to decide on tests or treatments for someone else, but usually there is some sense of what the person would say if they could.

Remember that the person has an underlying illness

It may feel to families as though these decisions could make the difference between life and death. Yet it is important to remember that the underlying illness itself is not survivable – no care decision can change that. Choices about healthcare options will not determine whether the person will live or die, but rather how their final days are experienced. The illness itself is bringing the approach of death, and healthcare decisions are focused on choosing the path that is most comfortable for the person who is dying and reflects the person's values.

What may help

Consider asking “What would the person want done if they were able to tell us?” rather than “What do we want done for them?” This way the decision-maker serves as the messenger for the patient’s known values and beliefs, rather taking on the responsibility for care decisions.