Deciding about treatment

Some people are happy to have whatever treatment their doctor recommends, but others like to know as much as possible before starting any course of treatment.

It is usually possible to take a bit of time to think about the treatment options, and discuss them with the people closest to you and the doctors and nurses looking after you. Your oncologist (cancer specialist) is the best source of accurate medical information.

Your doctor may suggest that there is no further treatment that can be given to control your cancer. This does not mean that ‘nothing more can be done’, but rather that the aim of treatment is changing. Rather than trying to shrink the cancer, the aim will now be to ease troublesome or distressing symptoms. This will make sure that you are comfortable and will give you the best possible quality of life.

It is important that you make the decision that feels right for you about which treatment, if any, you are prepared to have; even if your family or doctors may recommend otherwise.

Don’t feel under pressure from your family and friends to accept or refuse treatment. The final decision must be your own.

These questions and suggestions may help you make treatment decisions.

  1. What is the aim of the treatment?
  2. What will receiving this treatment give me?
  3. If it improves my quality of life will it impact on the length of my life?
  4. If it extends my life what will it do for the quality of my life?
  5. What if I don’t accept treatment?
  6. What’s causing the symptoms?
  7. What are the side effects of treatment?
  8. What can be done about side effects?
  9. Who will be supervising my care?
  10. Who do I call in the evenings or after hours?
  11. Do the oncologists, doctors, nurses, and palliative care team communicate about my care?
  12. Taking notes during the session can help.
  13. You may find it useful to take a family member or friend with you to take part in the discussion, take notes, or simply listen.
  14. Some people find it helps to record the session.

When treatment seems too much

Sometimes you will ask yourself if the treatment is worth it.

  • Before you stop treatment, give yourself time to think about it.
  • Are you feeling bad from the side effects of the treatment, from advancing disease, or from emotional overload? Some or all of these can be treated.
  • Talk with others, particularly your doctor and those close to you.
  • If you feel uncertain, you can speak to someone less closely involved – a counsellor, social worker, or call 0800 CANCER (226 237). These people may be able to help you to weigh up what is best for you.

“She hadn’t any further wish to be jabbed and scanned or struggle to keep appointments. She simply preferred to enjoy her time with me and inspired her visitors with her carefree determination and religious belief.” William 

“If I was told I had six months, but with a certain treatment I could extend it to one year, first off I would say, ‘What kind of side effects will I feel from the treatment?’

If they said my quality of life would be compromised greatly, I would say, ‘Forget it.’ I have had enough side effects to last me two lifetimes, I wouldn’t want any more.

Now that doesn’t mean I would be giving up, far from it. I would be fighting with every ounce of life left in my body.” Bess

Legal information

Enduring power of attorney

In the same way that treatment can prolong life, medical intervention can delay death.

There can be choices and decisions to be made about continuing treatment. It is difficult to know what you may want ahead of time. Some people have strong wishes and may want to know that these will be respected.

There are two types of enduring power of attorney. The one discussed here relates to personal care and welfare.

You may appoint an enduring power of attorney (personal care and welfare) and someone whom you trust to make medical decisions for you should you become unable to make competent medical decisions because of illness. You can get information about this from the New Zealand Law Society, your lawyer, or social worker. The point about an enduring power of attorney is that it comes into effect only when you are unable to make decisions for yourself.

Refusal of medical treatment

New Zealand law allows for the refusal of medical treatment if you wish, including palliative care, pain relief, and food and drink.

If you have appointed someone to act as your enduring power of attorney, he or she can refuse medical treatment on your behalf. For more information on both enduring power of attorney and refusal of medical treatment visit the web addresses that follow:

www.lawyers.org.nz/pubaboutlaw.asp

The New Zealand Law Society

The New Zealand Medical Association

You may be asked to discuss your wishes about resuscitation. It may be helpful to read the section on CPR on the CancerBackup website.

If you do not have internet access, call 0800 CANCER (226 237) for their assistance.

Your rights when receiving a Health or Disability Service

Whatever your decision is about treatment at any stage, you have the right to be treated according to the Code of Rights for Health and Disability.

Your rights are:

  1. To be treated with respect.
  2. To be treated fairly without pressure or discrimination.
  3. The right to dignity and independence.
  4. To receive a quality service and to be treated with care and skill.
  5. To be given information that you can understand in a way that helps you communicate with the person providing the service.
  6. To be given the information you need to know about your health or disability; the service being provided and the names and roles of the staff; as well as information about any tests and procedures you need and any test results In New Zealand, people are encouraged to ask questions and to ask for more information to help them understand what is going on.
  7. To make your own decision about your care, and to change your mind.
  8. To have a support person with you at most times.
  9. To have all these rights apply if you are asked to take part in a research study or teaching session for training staff.
  10. You have the right to complain and have your complaint taken seriously.

(Source: www.hdc.org.nz/theact/theact-thecode)

For more information phone the Health and Disability Commissioner’s Office on 0800 112 233.

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