End of Life Counseling EOLcounseling.com – End of Life Counseling

Having the Difficult Conversation: Counseling Your Patients on End of Life Decisions

Program Overview

Having the Difficult Conversation:  Counseling Your Patients on End of Life Decisions
The Patient Self-Determination Act of 1991 gave patients the right to deny medical care and preserved that right even when they are not capable of making medical decisions. 1 By law, all patients are asked on admission to the hospital if they have an advance directive.  In addition, studies have shown that patients want control of medical decisions at the end of life, and that they would like their primary care physicians to discuss the topic with them when they are still healthy.2  However, we know that fewer than one third of elderly individuals in the US have completed advance directives, which plan for end-of life care in the future when the individual is too ill to make decisions. Furthermore, even when they do, the forms are often inadequate in that they focus on procedures (such as CPR) and do not address many other common decisions.

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There is a large body of end of life literature which attempts to shift the discussion away from procedures toward goals of care at the end of life.  This module is designed to supply the primary care practitioner with the information and the skills they need to have these discussions with their patients in the office and complete advance directives.


Course Instructions
To receive credit, participants should complete all components of each module:
- Read, watch and listen to entire programs (text, powerpoints, and videos)
- Take the module post-tests (post-tests are available after tests and presentations have been viewed)
- Complete the evaluations

You will have 2 opportunities to pass the post-test.  In order to receive a CME certificate, you must achieve a score of 70% or greater.


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