What Is End of Life Counseling?

Jillian O Keeffe

End of life counseling involves a conversation between a medical professional and a patient about plans for his or her medical care when terminally ill. It covers such areas as whether the person wishes to be artificially resuscitated or die naturally, and whether the person would prefer to have strong drug treatment to lengthen life or mild treatment to give a shorter period of time with a higher quality of life. A person may enter into end of life counseling while still healthy, or when seriously ill. The counseling may be part of medical insurance plans, or may be separate.

A patient may enter into end of life counseling when terminally ill.
A patient may enter into end of life counseling when terminally ill.

Those who have life-threatening illnesses, or those who simply wish to lay out ground rules for their care before death, can enter end of life counseling with a doctor. This form of counseling may be included in a medical insurance package, or it may come up as part of a regular conversation with a doctor. Some people plan for their death, even when they are in good health, in case they fall ill unexpectedly. Whatever the motivations of the person involved, end of life counseling helps to get a doctor's advice on what the available options are if the worst case scenario does occur.

Elderly may discuss end of life issues with a counselor.
Elderly may discuss end of life issues with a counselor.

A doctor can generally tell the person what is to be expected in specific medical situations, such as if the patient goes into a coma, or into cardiac arrest. This information can help the person form a set of rules to be followed in the event of this happening, such as a living will. A plan of this type allows the patient to leave instructions for family and doctor as to what to do, taking difficult decisions out of their hands and back into the hands of the patient. He or she may then be able to choose between courses of treatment, or no treatment at all, depending on specific preferences.

Aside from the personal choices that a person makes for individual reasons, end of life counseling can have an effect on the cost of medical treatment for the terminally ill. Complex and aggressive treatment for serious conditions that may help prolong a person's life, but does not cure the illness, can cost much more than a mild treatment that helps keep a terminally ill person comfortable. Some insurance providers have offered end of life counseling as part of an insurance package for those facing this choice.

Opponents of end of life counseling availability worry that medical staff in positions of authority may not give the patient all of the information necessary to make an informed decision. Another concern is that vulnerable patients may be led into making the wrong decision for him or her by a biased doctor. Discussions of this nature are also tricky for doctors, as they may also distress those who do not wish to fully face their mortality, but this may be easier for people who enter end of life counseling before any terminal illness occurs.

A doctor may use end of life counseling to inform the patient of the things to be expected during specific medical situations.
A doctor may use end of life counseling to inform the patient of the things to be expected during specific medical situations.

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