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4 Steps For Making Better Decisions

A woman with outstretched wings is standing on the prow of a ship. Her garments are twisting and billowing in the wind.
Author’s photo, Winged Victory of Samothrace, The Louvre, Paris

Have a “c-a-r-e” mnemonic for informed consent

Whether we are buying, selling, serving, being served, being cared for or triaging ventilators, we all have an obligation to be truthful and a right to be fully informed as we make decisions. It is our duty to facilitate individually determined decisions especially for those who need our assistance to live their life-long values.


C- Capability determinations are pivotal for healthcare and financial decisions. Capacity for EACH decision is individually determined through the decider’s performance in the informed consent process in the 3 steps to follow. E.g. Consent for help with toenail cutting requires different skills than refusing dialysis, driving a car or making a new will.

A- Appreciate alternatives-explore the range of least to most intrusive choices/interventions

R- Referencing their own situation, they must Reason through the Risks and Benefits;

E- Express understanding having had opportunities for questions. Explain their choice in their own words, made without coercion or potentially reversible influences such as misinformation, fear, depression and pain.

Covid-19 strategies are grounded in truth and trust taking us well into the impingement of individual rights for the greater good. When all else is equal in terms of who is in the line for ventilators, that is having equally projected survival, my family knows I wish to give my ventilator to someone who has had less innings, less opportunities in life; someone who has yet to be a wife, mother and grandmother. That is my informed decision, personally intrusive but likely with a fair outcome.



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Isak Dinesen

Isak Dinesen

"Don't ask what the world needs. Ask what makes you come alive. What the world needs is people who have come alive. " - Howard Thurman (AfricanAmerican)