• Laurie Mallery, Anne-Marie Krueger-Naug, Paige Moorhouse, Ashley Paige Miller, Maia von Maltzahn, Amanda Tinning, and Nabha Shetty.
• Dalhousie University Faculty of Medicine, Department of Medicine, Halifax, Canada.
• J Palliat Med. 2024 Oct 1; 27 (10): 129713021297-1302.

AbstractHealth care professionals can enhance conversations about serious illness and medical decision-making by adopting a transparent, standardized approach. This article critiques established communication strategies, which often emphasize patient values and goals without providing the necessary medical information to align these goals with a shared understanding of prognosis. We propose an alternate strategy that (1) provides detailed explanations of medical conditions at the beginning of the conversation, (2) includes support persons in discussions, (3) considers capacity, and (4) offers tailored advice by clinicians. The proposed framework aims to provide patients (or their delegates) with the information they need to integrate their values in pursuit of well-informed medical decisions. This strategy builds trust by providing honest information about medical conditions and their trajectories. It empowers decision makers to consider realistic outcomes, allowing them to accept or reject treatments in accordance with their preferences. This article presents a thorough step-by-step guide on how to conduct a serious illness conversation and facilitate medical decision-making, including a supplement that provides example phrases for use in clinical practice.

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