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Point of View: It’s time to change how we talk about health care.

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Dr. Timothy Ihrig
Dr. Timothy Ihrig

National Healthcare Decisions Day is held each year on April 16. It exists to inspire, educate and empower the public and providers about the importance of advance care planning.

I am a palliative care and hospice physician. Every day I support shared decision making based on true informed consent with every patient I care for. I want to encourage everyone to take the time to do the same — with their patients, loved ones and themselves.

Unfortunately, a majority of individuals are faced with important healthcare decisions in acute, crisis situations — when emotions such as fear and hope, faith, commitments, blur reality. At these times, regardless of disease and clinical truths, the question too often asked is, “Do you want to die?" This is the wrong question. It precludes clarity, honesty, true shared decision making or true informed consent where one is empowered with the understanding of the realities about diseases, their trajectories, outcomes and all options of care.

Whether it be widely spread cancer, congestive heart failure or no disease at all, the absolute physiologic reality is that all of us are going to die. When we fail to acknowledge this, we lose the opportunity of writing the chapters of our lives based on want we want done with us and for us, rather than to us.

Thus, we need to reframe the narrative. While most look at making health care decisions when we are healthy as focusing on how we want to die. I offer the opposite. It is about how we want to live.

I don’t want to die any sooner than is my time. Again, it's the absolute reality that I am going to die. Such tone is neither pessimistic, morose or negative. It's the truth, one we can’t escape. Death, however, occurs after the exhalation of our last breath. Everything prior to that is life. We — physicians, patients, caregivers, the health care system, society — need to transcend the current fear-of-death approach of how we think and converse about health care decisions, including advanced care planning.

By accepting the reality of life, one can make decisions about the care one would want to receive if they become unable to speak for their self. These are your decisions to make, regardless of what you choose for your care, and the decisions are based on your personal values, preferences, and discussions with your loved ones. The decisions are based on what is sacred to you.

Overcome fear. Don’t be scared to talk about life. Change "scared" to "sacred." Change the narrative. Change your narrative. Take time to think about and share how you want to live.

The truth is a different voice in healthcare that helps all of us find our own.

Ihrig is chief medical officer of Crossroads Hospice & Palliative Care and CEO of Ihrig MD & Associates.

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