I find this discussion most interesting. I sometimes wonder if we in health care, however, have a skewed perspective of what others' priorities may be. We are educated to believe that physical health (and mental health) should be a primary goal for every person. I do not believe this is so for everyone. For example, family, or intellectual study or spirituality may be most significant in someone's life. A person may persist in an unhealthy employment, because it supports the family well, or maintain a sedentary lifestyle because there is such deep gratification to be gained from study, or appear unmotivated to pursue life saving therapies-- because they are satisfied with their life and comfortable with death spiritually.
I agree that we must educate patients well, but we shouldn't feel we or they have failed if they choose to make choices we consider unwise.
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