Thinking about your values
Values are personal feelings or beliefs that are most important to you when thinking about medical treatments that you might be offered when you are seriously ill. Your values are a big part of medical decision-making. It’s not what your family thinks is important. It’s not what your doctor thinks is important. It’s really what you think is important.
Some people find this part of the website a bit difficult. Dr. Heyland explains how to think about your values in the video below, and shows you how to use the different grids and scales that you’ll find on this page. Click on the arrow in the image below to watch the video:
Here are some examples of values you may want to think about:
- I want to live as long as possible
- I want to avoid the use of machines in order to keep me alive if I am seriously ill
- I want to avoid symptoms such as pain and shortness of breath
- I want to live as independently as possible
- I want to continue to be able to participate in activities I like to do
- I want to be able to think clearly and not be in a constant state of confusion
Remember: we are not making medical decisions today – we are talking about what would be important to you if you were seriously ill so you and your family are prepared.
Some values conflict or compete with each other
Sometimes, two things that you say are important may conflict with each other. For example, if you say, “a natural death is most important to me,” and “keep me alive at all costs,” you may not be able to have both. Keeping you alive at all costs means the health care team might have to use life-supports and other machines to keep you alive. The use of these machines will take away from you having a natural death.
You should also think about quality of life vs quantity of life. We all hope that we will live well up until the end. But that doesn’t happen very often. You may have a sudden change in health or a gradual change over time that can affect your quality of life. Sometimes, those changes can mean you end up in a condition that you may consider worse than death.
It is important for your Substitute Decision Maker and your doctor to understand which of these values is more important to you. Two people with the same age and same medical condition may have different views.
If quantity of life is more important than quality of life, doctors may use machines to try to keep you alive as long as possible, even if that reduces your quality of life. If you value quality of life over quantity of life, doctors may focus on different treatments that maintain quality of life, even if it means that you might not live as long. Remember: there is no crystal ball. Medical doctors can’t always tell how things will turn out for you. But knowing what is important to you will help with decision making if you are seriously ill and can’t speak for yourself. Before we show you how our values connect to the medical treatment options, let’s explain to you what are the various medical treatment options available to treat serious illness.
Using Your Value Statements to Connect to Your Medical Treatment Preferences
When you make your plan in the “Make a Plan” section of this website, you will be asked the following questions using these scales that will help you identify what is most important to you:
Which treatment options are right for you?
To help you figure out what treatment options are right for you, we take these scales above and put them together to form a grid (see image below). We then take your answers using the scales and put them on the grid too. We then draw a line to the right from your answer to question 1 and another up from your answer to question 2 until they meet in one of the small squares. The square where your 2 answers meet indicate what medical treatments are right for you.
In each of these squares in the grid are statements of different medical treatment options shown below. By doing it this way, you will be able to see how your values (or what is most important to you) connect to the various medical treatment options and figuring out which one is right for you.
We don’t expect you to understand what these different treatment options are right now. In the next section, we will explain them to you. Right now, we are preparing you for the planning process you will go through when you ‘make your plan’. For now, think about the answers to these scaled values questions above and why you chose your answers. You will be asked to record your reasons why. You will be able to answer these questions and save this information when you make your plan.
Please Note: There is a relationship between the answers to your values questions and the medical treatments in each of the squares. If you land on the grid in a square that suggests a medical treatment that does not match what you think is right for you, you will need to go back to the values questions and review and possibly change your answers. If you find your answers to the values questions lead to one of the 2 black boxes, your doctors won’t be able to figure out which treatment is right for you so you need to go back and change your answers. If you land on the grid right between two treatments or you can’t decide between two treatments, don’t worry. You will have a chance to discuss this with your doctor and they will help you get what is right for you.
Think about the answers to these important questions.
You will be able to answer them and save them when you make your plan.