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Communicating about a serious illness is hard. Last week\u2019s podcast we talked about the challenge around miscommunication in serious illness. This week we dive into the challenges with communication when it comes to life sustaining treatments and CPR. Take for example the simple question:

\u201cIf her breathing gets any worse, she will need to be intubated.\u201d

This seems like an innocuous statement of fact, but does she really \u201cneed\u201d to be intubated if, for example, her primary goals are to be comfortable and die at home?\xa0 Of course not.\xa0

We\u2019ve invited Jacqueline Kruser and Bob Arnold on this week's podcast to talk about their recently published JAMA Viewpoint article titled \u201cReconsidering the Language of Serious Illness.\u201d I love this article as it specifically discusses what\u2019s wrong with \u201cneed\u201d statements and how we can shift our communication and thinking to create space for deliberation about patients\u2019 priorities and the best course of action.\xa0\xa0

We\u2019ve also invited Sunita Puri to talk about the language of life sustaining treatments, in particular CPR. Sunita recently published a wonderful New Yorker article titled\xa0The Hidden Harms of CPR arguing among other things that these conversations \u201care procedures, demanding the same precision of everything else in medicine.\u201d\xa0

So take a listen and check out some of these other links to dive deeper:

• Our first podcast in the series of 3 podcasts \u201cMiscommunication\u201d

• A great article on why you shouldn't ask what patients \u201cwant\u201d

• Sunita\u2019s book That Good Night: Life and Medicine in the Eleventh Hour

• The paper Jacky talked about regarding the ingrained pattern of focusing on the \u201cneed\u201d for specific life-sustaining interventions, typically as the reason to admit a patient to the ICU

• Changes in End-of-Life Practices in European Intensive Care Units From 1999 to 2016

• Cardiopulmonary Resuscitation on Television \u2014 Miracles and Misinformation

• Code Status Discussions Between Attending Hospitalist Physicians and Medical Patients at Hospital Admission