| Philosophy of care | Ask:
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What are the medical, ethical, social, and cultural principles that will guide my decisions and discussions with the family?
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| Assessing the evidence | Consider:
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Comparing evidence-based medicine vs evidence-informed medicine -
Developing critical appraisal skills -
Cultivating reliable sources for gathering up-to-date evidence
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| Understanding expectations | Ask:
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What are the expectations of the patient, his or her family members, and his or her substitute decision maker? -
What are my expectations for this patient’s care? -
How can I align the multiple expectations to foster collaboration with the family?
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| Simplify | Ask:
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Does this patient require this medication? What are the risks of continuing or discontinuing this drug? -
Is this intervention or test absolutely necessary? What will I do with the information afterward? -
How do I communicate this plan consistently to the rest of the health care team?
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| Evolution of care | Ask:
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Has there been a status change in the patient? -
Have the caregivers or family members been informed of this status change? -
Have the goals of care changed since the change in status?
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