| Cancer stage | Values conversation depicted | ACP outcomes encouraged |
---|---|---|---|
Vignette 1 Early cancer diagnosis | Early diagnosis, good performance status | Active treatment to preserve life at any cost | Appointment of a Medical Treatment Decision Maker and Support Person |
Vignette 2 Living with serious illness | Progressive metastatic disease, deteriorating performance status | Sustaining a reasonable quality of life through illness. Reflection of values and reprioritization of life choices | Completion of Values Directive. Consider when to discontinue cancer treatments / accept or refuse treatments based on acceptable quality of life |
Vignette 3 Approaching the end of life | Advanced metastatic disease, increased dependence | Effects of progressive frailty on quality of life despite active treatment. Reflection of meaningful relationships and EOL values | Completion of Instructional Directive. Discuss cardiopulmonary resuscitation, invasive/life-prolonging interventions, preferred place of death, contingencies e.g. funeral plans, spiritual needs. |