Family members are often asked to make a decision for someone at the end of life. Unless it is clearly defined and recorded by the terminally-ill person who has already created a will, or has expressed verbally wishes, opinions, and feelings, one must take into consideration the values of the individual. What were the important pieces in life? Was it family? Was it life itself? Was it socialization? Was it spirituality? If one knows, one can make an educated decision; however, at times, it is essential to ask the doctor and get some real answers based on facts.

John has just been informed that his mother's treatment for her advanced metastatic melanoma has not produced any positive results. His mother Maria is 90 years old, and John is the only son among three daughters. Since Maria has not written any of her wishes, in her culture, in the absence of a husband, the son must make all health care decisions; however, John being sensitive of his sisters' feelings, they all have a family conference with the doctor, who is prescribing a new course of treatment. They have written a set of questions, and one of the sisters has been designated to keep the notes.

Following are the significant questions whose answers can guide John and his sisters to the right decision:

• Why is the new treatment being suggested?
• How will it be different than the previous one?
• Will our mother feel better, or even improve?
• How will this treatment affect her quality of life?
• If we agree to move forward, can we change our mind later on?
• What are the side effects of this treatment?
• Will the level of her comfort be better, or worse?
• Should we decline the new therapy treatment, what will happen next?
• Is there another alternative therapy, or state of existence?
• What is your opinion of Hospice Care for our mother?

Remember that you do not have to decide during the conference. The best approach is to discuss it in a peaceful and meaningful way, and through reliving some of the great moments in her life. Eventually, every family member will have ownership in the process, and it will achieve amicable results, but above all, it will be for Maria's best interest.