Controversial take here but when talking about death, asking #whatmattersmost in acute care is not easy and not always relevant and it may be great in a hospice, or at home, if a person actually knows what’s wrong with them, but it’s too vague for most of us in day to day work

It also runs the risk of giving people the illusion of choice - treatments and options that simply aren’t appropriate - and I think we need a different question. I’ve spent almost twenty five years trying to find it. Which makes me conclude - perhaps it’s different for everyone?

So we need to spend our/patient/family precious time a) being clear about medical issues and honest about outcomes b) knowing a bit about the patient as a person and c) realising that, as with most things in life, done is better than perfect.

God but it’s hard on the phone though.