Alaina Malik, MHC-LP

If someone you know has chosen not to engage in life-saving medical treatment, it can be difficult and confusing to support your loved one’s resistance or reluctance to live.

Everyone’s picture will look different. The person you know may have decided not to engage in treatment to help survive cancer or not engage in surgery for the heart, or some other medical treatment that could help them live. This post is meant for you: the loved one, on how to cope with someone’s choice not to get the treatment that would lengthen their lifespan.

Is it suicide or not? This is a difficult question to grapple with and your conclusion could differ from that of your loved one. Spirituality and religion play a role here, too. The patient might not see this as choosing to end their life, but as having faith—when it’s time, they will depart on their own terms.

The key is you may not support their choice, and you don’t need to. But, we must offer acceptance of their choice, even if acceptance comes after pleading and bargaining with them. Other circumstances in the patient’s life could factor into their decision to not participate in the treatment: finances, emotions, spirituality.

Word your confusion as a curiosity. What doesn’t make sense to you regarding the patient’s wish not to participate in the medical treatment—ask them. Your voice is as important as theirs. Can you hear their understanding of the situation? Ask them how they’ve come to terms and acceptance of not having the treatment. Maybe they’re scared, but can’t say it. Leave room in the conversation for the patient’s vulnerability and honesty to breathe. The hardest part here is to contain your fear while hearing them out.

Coping with a preemptive loss is scary, and can also make you angry. If you’re feeling afraid, angry, confused, hopeless, helpless, or more—that’s okay—given the circumstance. Your emotions are valid. But remember that the patient’s emotions are equally valid. It’s an autonomous decision on their part and accepting something that goes against your wishes or desires is hard.

Engaging in mental health counseling for yourself can help you process the discomfort of the preemptive loss. Talking to other friends and family about the patient’s choices in trying to find understanding can also be helpful. Remember that you may not know how much time they have left, so cherish your relationship with the patient.