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Competing Values – Part 1

Competing Values – Part 1

What makes tough decisions so darn tough? Usually it is because you are faced with a choice or dilemma that involves equally compelling and seemingly competing principles and values. This is especially the case when confronting questions and issues around caregiving, where choices can often appear to be in opposition. Here is a recent experience to illustrate the point. Mary and Ann are sisters, both in their 90s and living thousands of miles apart. Mary’s Alzheimer’s was advanced, while Ann was just starting to present the first stages of Alzheimer’s disease. Both Mary and Ann have loving adult daughters, committed to providing care and support. Mary caught the flu, and given her fragile state, was not recovering at all. After a couple of months of more aggressive interventions, the medical team moved Mary to palliative care to be more comfortable as they anticipated her passing in the coming weeks. Mary and Ann’s daughters both decided to not tell Ann about Mary’s failing condition. Although I respected their decision to keep this information from Ann, I didn’t agree with the decision. My passionate attachment to the value of self-determination was bumping up against the daughters’ equally passionate value to keep Ann safe and protected from disturbing news for as long as possible. Self-determination versus safety – a common dilemma. I held the conviction that we had no right to withhold this information from Ann. She certainly had the mental capacity at this stage to understand the implications – so we needed to respect her right to self-determination. Yes, she would be sad, but who are we to deny her this...