Bioethics Blogs

Let’s Talk About Wishes, Values, and Beliefs

Angel Petropanagos reflects on her experiences asking dialysis outpatients questions about healthcare wishes, values, and beliefs.


I want to tell you about one of the most rewarding ethics projects I’ve been involved with. Over the past few months, I’ve been speaking with dialysis outpatients about what they want, what’s important to them, and what they believe. I’ve been asking them about who they want as their substitute decision-maker if they lose the capacity to consent to treatment, and whether they have or would like to have a living will (or a Power of Attorney for Personal Care). I’ve been asking them if they have any wishes related to receiving Cardio Pulmonary Resuscitation if their heart stops. I’ve also been asking them how they feel about their dialysis treatment. With these types of extremely challenging personal and moral questions I’m getting to know a lot about these patients.

Most of these conversations have happened at the bedside while outpatients have been receiving their dialysis treatment. Often, when I have asked patients these questions, they have smiled at me, paused to reflect, or just laughed. Some patients have told me that they had never thought about their healthcare wishes before. Others have told me that they were glad that someone was finally asking them about their wishes.

These conversations are part of an ethics quality improvement project called ChELO (Checklist to meet Ethical and Legal Obligations). Ethics quality improvement is a novel approach to clinical ethics that aims to improve quality of care. Improved quality of care means giving patients care that they want and can benefit from.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.