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Time to "Talk Turkey"

Posted by Dr. Lachlan Forrow  November 20, 2012 06:26 PM

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As we gather this week with loved ones, I suspect that few of us have on our “wish list” a conversation about “death and dying.”

But I also suspect that not a single one of us ever wants to be in the position of having to make a major medical decision on a loved one’s behalf, but have no idea what the person we love would want us to do.  Nor does any of us want any loved ones to be in that nearly-impossible position for us – which will likely happen if one day they have to make a major medical decision about us, but we have never told them what we would want them to do.

But somehow we still manage not to talk about it.  We don’t even talk to our own doctors – a Massachusetts AARP survey found that only 17% of respondents had ever spoken with their physicians about their end-of-life preferences.

This needs to change – but how?

Sometimes a little bit of humor can help.

Since 1999, at Beth Israel Deaconess Medical Center, we have organized a “Talk Turkey” program each year during the days leading up to Thanksgiving.  We first did this in partnership with the Massachusetts Medical Society, using wonderful materials that they provided, which we have since adapted.  Each year, staff at tables outside each cafeteria, and in other high-traffic areas, sit by posters with variations on the theme of “It’s Time to Talk Turkey”, handing out information about “advance directives”, and copies of the standard Massachusetts Health Care Proxy form.  The form is simple – no lawyer needed – and anyone over 18 can give full legal authority to the person they would want to make medical decisions on their behalf, if it ever becomes necessary.

Every year we distribute over 1,000 Massachusetts Health Care Proxy forms to staff and visitors.  Every year, a growing number of people who pass the tables say they don’t need one this year, because they got one (or several) from us in the past.  Some even tell us that they and their loved ones have talked about the issue since last year, completed the form, and given copies to their physicians.

Of course, the point is not the form itself, it is the conversation that the form is designed to trigger.  The hardest part of “the conversation” is getting started.  For people who have stopped by one of our “Talk Turkey” tables, we suggest that one way is simply to say:

“Do you know what they were doing at my hospital this week?  Something called “Talk Turkey”… I realized that I’ve never told anyone what I would want if I was ever very sick…”

Some people find, when they are remembering together a family member who has passed away, that it is natural to think about the last phase of that loved one’s life. Was it approached the way s/he would have wanted?   What would each of us want for ourselves?  How can we make sure our loved ones know?

This year, a conversation could start about why the Question 2 debate about proposed legalization of physician-assisted suicide gained such high profile, even though we know from Oregon that only 2 out of 1,000 people choose that option.  It’s obvious that there is intense and widespread interest in what the last phase of life may be like.  So a conversation about Question 2 could spark you to say “This is what I would want if I was ever seriously ill – what about you?”

Other ideas about how to "start the conversation" are provided by The Conversation Project in its "Starter Kit".

In fact, these conversations are not really about “death and dying” at all.  They are about life.  And when we have helped each other learn to have “the conversation”, then more and more often at future Thanksgivings, we will be able to look back at the life of a loved one we miss, and say that in the last phase of life “she was taken care of just the way she would have wanted.” And for that, we can be deeply grateful.

So please don’t miss any chances this week to “Talk Turkey.”

And have a Happy Thanksgiving.

This blog is not written or edited by Boston.com or the Boston Globe.
The author is solely responsible for the content.

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About the author

Lachlan Forrow, MD is Director of Ethics Programs and Director of Palliative Care Programs at Boston's Beth Israel Deaconess Medical Center and Associate Professor of Medicine at Harvard Medical School. More »

Have you had the conversation?

Learn why and how to start discussing end-of-life wishes with your family. Join The Conversation Project.

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