If the discussion instead begins with, “I’m so sorry that this is the diagnosis, and I know we’ve discussed the prognosis already, and it’s difficult to face. Would it be alright if we talk a bit about how you envision spending your time, from now until whenever the end may be?” One patient may reply, “I want my family to know that I did everything possible to beat this cancer. If there is a clinical trial that gives me a one percent chance of another day, sign me up, I don’t care how rough it is.” Another may say, “I watched my mother die of cancer. The treatment made her so sick, I often
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