5. Case Example: Choice

The aim of this section is to explore the link between patient self esteem and self determination (choice) and to consider the benefits of collaborating with patients and their family members to maximize patient autonomy and satisfaction.


Choices vary tremendously from person to person depending on how a disease or condition affects their daily life. As healthcare professionals, we may wrongly assume that seriously ill or terminal patients rate their quality of life as poor. However, if symptoms are well managed and the patient’s needs are met, a terminally ill patient may feel that their quality of life is good. For instance, they may take part in an event that brings them happiness, such as the birth of a new grandchild. Another patient may refuse increasing pain medications in order to talk coherently with loved ones at the end of their life. To them, being able to communicate outweighs their pain management—it’s their choice. Others may wish to remain alive at all costs—again, this is their choice. These examples further illustrate the individualized nature of palliative care.

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