Advance care planning (ACP) is a process for patients and their families to discuss their wishes and goals of care for treatment and end-of-life care, clarify related values and goals, and state preferences through written documents and medical orders. In situations where a patient’s decision-making capacity is limited, healthcare providers turn to family members to make decisions. When no ACP conversations have occurred between patients and their families, family members are left to make decisions regarding life-sustaining treatment without input from the patient or with little knowledge of the patient’s wishes.

Senator John McCain’s (R-AZ) family announced on August 24, 2018, that McCain has elected to stop treatment for his glioblastoma, a rare and aggressive form of brain cancer. Although his health had surpassed his original prognosis for many months, “the progress of disease and the inexorable advance of age render their verdict. With his usual strength of will, he has now chosen to discontinue medical treatment,” his family explained.

ONS joined the Patient Quality of Life Coalition (PQLC) in signing a final comment letter to the Centers for Medicare and Medicaid Services (CMS) administrator, Seema Verma, on the agency’s proposed 2018 updates to the Quality Payment Program, CMS-5522-P. PQLC, which represents patients, health professionals, and healthcare systems, advocates for palliative care for patients and families facing serious illness.

The American Nurses Association (ANA) launched a grand challenge this year: Healthy Nurse, Healthy Nation. The premise is that we are the largest health professionals group but also rate poorly on health indicators. If we improve our health, we can be role models for our family, friends, patients, and community. ONS is supporting the ANA challenge, and I hope you have seen the weekly ONS tips that will help in this challenge.

In late June, I had the opportunity to wear two advocacy hats: one for ONS, and one for the National Coalition for Cancer Survivorship (NCCS). It was an incredible experience to walk the halls of the U.S. Congress to help educate elected officials and their staff on legislation that affects cancer care.

Daniel is a 55-year-old male diagnosed with stage III nasopharyngeal cancer. He lives with Jon, his partner of 4 years. One day, he is taken by ambulance to the ED where it is determined he had an ischemic stroke. He has no advanced directives or living relatives. What would you do?