End of Life Palliative Care

END OF LIFE

End of Life

Jane is a 57-year old African-American women who was diagnosed with stage 4 cervical cancer 2 months ago. At this advanced stage, the disease is largely considered terminal. This is more so the case given that following review, doctors indicated that the said disease could not be cured and, thus, there was no need to put the patient on any aggressive or advanced treatment with the end goal being to cure the disease. Towards this end, a decision was made to put Jane on treatment to control her symptoms. More specifically, it was recommended that Jane undergoes radiation therapy with the specific aim of not only controlling her symptoms, but also stopping bleeding and easing pain. Jane’s family has been very supportive so far. She is married to Jordan, a 64-year-old veteran. Together, they have 3 children who are all adults and married.

Over the last two weeks, Jane has been showing signs of distress and anxiety. She indicates that she wants to “leave this planet” as soon as possible so as to ease her family’s suffering and “release them to pursue other more meaningful engagements in life.” She is concerned that they are “unnecessarily spending resources” on her and is convinced that she is “wasting their time” on constant visitations and in terms of the various demands of care. She sees the stoppage of treatment as the only way to hasten her exit from this planet. As a result, she has refused further treatment.

It would be prudent to note that in line with the principle of autonomy, patients generally have the right to refuse care and/or treatment. Indeed, in the words of Davey, Rathmell, and Dunn (2016), in line with this particular principle, “every person has the right to make informed decisions about their healthcare and that healthcare professionals should not impose their own beliefs or decisions upon their patients” (107). Towards this end, there would be need to deploy the relevant counselling approaches in efforts to convince Jane to accept treatment. On this front, I would be in favor of deploying the Rational Emotive Behavior Therapy approach (REBT). This particular approach has been described by Conte (2009) as a kind of CBT that largely concerns itself with enabling individuals to rein in their irrational beliefs and develop the skills and capabilities needed to gain better control of their thoughts. Thus, as the author further indicates, this is an ideal counseling approach in dealing with individuals whose thoughts and beliefs happen to be rather irrational. In the case of Jane, her thoughts about overburdening her family with her healthcare needs is largely irrational and is not founded on fact. This is more so the case given that this is a family that happens to be financially stable, and her husband and children have shown commitment towards the promotion and advancement of her wellbeing. In this case, I would specifically utilize the REBT’s ABC model. This particular model, in the words of Conte (2009), “explains how, while we may blame external events for our unhappiness, it is our interpretation of these events that truly lies at the heart of our psychological distress” (179).