When Someone You Love Makes a Medical Decision You Disagree With

Section 1: When Someone You Love Makes a Medical Decision You Disagree With

Have you ever watched someone you love make a decision about their health and wondered how they could possibly think it was the right one?

Maybe they refuse a treatment their doctor recommends. Maybe they pick up a prescription but never take the medication. Or perhaps they keep putting off a medical appointment even though something is clearly wrong.

You talk about it. You explain why you're worried. You offer to go with them to the doctor, help them find another opinion, or learn more about their options. But nothing changes.

And that's when it gets hard.

How do you stop trying to convince someone when you're afraid their decision could cost them their life?

I have struggled with that question myself, and I know there isn't a simple answer.

What I've come to understand is that loving someone doesn't give us the right to make their medical decisions. We can offer help, share our concerns, and make sure they have the information they need. But when an adult is capable of making their own decisions, we cannot make those choices for them.

Understanding that is one thing. Learning to live with it is something else entirely.

Section 2: Understanding What Matters to the Other Person

You know, when someone we love is having health problems, we don't always understand why they hesitate to see a doctor or follow through with recommended tests. We may think the sensible thing is to find out what's wrong and deal with it, but the person we're worried about may not be ready to do that.

I remember when my husband's PSA first came back elevated. Nasser asked the doctor if he could wait a little while to see whether it would go down. The doctor agreed to repeat the test in three months, but when the results came back, his PSA was even higher.

This time, the doctor told him he needed a biopsy. Nasser still wanted to wait and tried to convince the doctor to continue monitoring his PSA instead.

I was sitting there listening to this conversation, wondering how much longer he wanted to put it off. I could see that he didn't want to face the possibility of cancer, and I was concerned that he was beginning to go into denial.

After that appointment, Nasser and I talked again. I reminded him of what had happened with my father. His doctors hadn't expected his cancer to advance as quickly as it did, and that experience had stayed with me.

I told Nasser that we couldn't know what we were dealing with until he had the biopsy. If it was cancer, we needed to know what kind it was and what treatment might be appropriate. Waiting another three months wasn't going to give us those answers.

I also knew he was worried about the biopsy itself, so we talked about making sure he would be as comfortable as possible and that his pain would be managed.

After that conversation, he agreed to have the biopsy.

Looking back, I can understand why he wanted more time. Sometimes we hope that if we wait a little longer, the problem will go away and we won't have to face something we're frightened of.

But understanding why someone wants to wait doesn't necessarily make it easier to watch them do it.

I think that's where many of us struggle. We want to help, and we may believe we know what needs to happen next. Yet the person we're worried about is the one who has to undergo the tests, hear the results, and live with whatever comes afterward.

Sometimes a conversation does make a difference. In our case, Nasser agreed to have the biopsy. But I also know from experience that not every conversation ends that way.

Section 3: Why We Sometimes See Medical Decisions Differently

Most people aren't going to come right out and tell you they're afraid of finding out the truth. Sometimes it's easier to put off the appointment, the test, or the treatment than to face what the doctor might tell them.

And when you're the person who loves them, that can be difficult to understand. You want them to get the medical care they need, and they may be doing everything they can to avoid it.

I believe this is when we need to be especially gentle with each other. Instead of pushing harder, we need to recognize that fear may be part of what's happening and be willing to face that fear with them.

You can reassure the person you love that they don't have to face whatever comes next by themselves. You're their partner, their backbone when they need one, and you're going to be there through each step.

You don't have to figure out everything today. You can face the next appointment, hear what the doctor has to say, and then decide what needs to happen afterward. One step at a time, together.

I also know that being someone's partner and backbone doesn't mean making their medical decisions for them.

I may not agree with the decision Nasser makes, and I may worry about what will happen because of it. I'll do everything I can to help him get the information he needs. I'll research the options, help him prepare questions for his doctors, and support him in getting another opinion if he wants one.

But in the end, the decision is his to make, and mine to accept.

That doesn't mean I have to agree with him. It means I have to respect his right to decide what happens to his own body, even when I wish he would make a different choice.

Section 4: When There Is More Behind a Medical Decision

When someone we love refuses medical care, we may assume they're afraid of what the doctor will tell them. Sometimes that's true, but there are many other reasons people put off appointments, refuse tests, or decide against treatment.

Research has shown that people avoid medical care for reasons ranging from cost and difficulty getting appointments to unpleasant experiences with doctors. Some don't believe their symptoms are serious enough to need attention. Others are worried about what a test might reveal or what treatment will involve.

I think this is important for us to understand because we can't help someone work through a concern until we have some idea of what that concern really is.

Someone who is worried about the cost of treatment may need help finding financial assistance. Someone who has had a painful medical procedure may need reassurance from the doctor about how discomfort will be managed. And someone who doesn't trust the medical advice they've received may be more comfortable seeking another opinion.

But there's another situation we need to talk about, and I believe it's one of the hardest for families.

What happens when the person you love has received a diagnosis, understands what the doctor is recommending, and still decides not to have the treatment?

They may have listened carefully, asked questions, and considered the possible consequences. Their decision may not be the one the doctor recommends, or the one you would make in their place.

For some people, quality of life is an important part of that decision. They may be willing to accept certain medical risks rather than undergo treatment that could leave them with lasting side effects or take away some of their independence.

Others may worry about the financial burden on their family or have personal beliefs that influence which treatments they're willing to accept.

These aren't always decisions made out of fear or denial. Sometimes people have thought carefully about what matters most to them and have reached a conclusion that someone else finds difficult to understand.

I remember how important quality of life was to Nasser when we began discussing prostate cancer treatment. Even before his biopsy, we talked about what mattered most to him if he did have cancer. His greatest concern was incontinence. He also hoped to preserve his ability to have an erection.

Once we had the biopsy results, those concerns became part of our conversations with the doctors about treatment options.

I understood why those things mattered to him. They were part of how he wanted to live his life, and I knew that whatever treatment he chose, he would be the one living with its effects.

That's something I hope we can remember when we're struggling with a medical decision someone we love has made.

We may be thinking about the possibility of losing them. They may be thinking about what their life will look like if they accept the treatment. Both concerns deserve to be heard.

And before we try once more to change their mind, perhaps we need to understand what they're trying to protect by making the decision they have.

Section 5: When You and Your Loved One Disagree

There may come a time when you've listened to the doctors, discussed the options, and still find yourselves disagreeing about what should happen next.

You believe the treatment is worth trying. The person you love doesn't. You've read about the benefits, and you're worried about what could happen if they refuse. They may be more concerned about the side effects or how treatment will change their everyday life.

I know how difficult these conversations can become, especially when you're frightened about the future. You want the person you love to understand why you're worried, and you want to know they've given the decision enough thought.

But after you've explained your concerns, what do you do when they still don't agree with you?

I would begin by asking them to help me understand what troubles them most about the doctor's recommendation. Then I would listen, even if I thought I already knew the answer.

Sometimes the concern is something you can work through together. Perhaps they don't understand why the doctor recommends a particular treatment, or they're worried about side effects and haven't had an opportunity to discuss them. Those are questions you can take back to the medical team.

Other times, the disagreement goes deeper. The person you love may understand the recommendation perfectly well but feel that the treatment would take away too much of what makes life enjoyable or meaningful to them.

That's much harder to resolve because you're no longer discussing only medical information. You're talking about what each of you is willing to live with.

I believe we have every right to tell the person we love how their decision affects us. We can explain our fears and ask them to consider another opinion. We can offer to help gather information or accompany them to an appointment.

What we need to be careful about is allowing those conversations to become a constant effort to change their mind.

Imagine being asked the same question every day after you've already given your answer. Eventually, you might stop talking about it altogether, not because you've stopped caring, but because you don't want another argument.

I wouldn't want that to happen between Nasser and me.

I want him to feel comfortable telling me what he's thinking, including the things he knows I may not want to hear. And I want to be able to tell him when I'm worried without making him feel that he has to agree with me to keep the peace.

Sometimes we need to give each other a little time before returning to a difficult conversation. We can ask whether they're willing to talk about it again, rather than bringing it up every time we're together.

And if the decision remains the same, we may have to accept that we've said everything we can say.

That can be painful, particularly when we believe the consequences could be serious. But continuing to argue doesn't necessarily bring us closer to agreement. Sometimes it only makes it harder for the person we love to turn to us when they need support.

Section 6: When the Decision Is Theirs, but the Worry Is Yours

There is something particularly difficult about accepting a medical decision when you believe the person you love may be putting their health, or even their life, at risk.

You may have been part of every conversation with the doctors. You've listened to the recommendations, read about the treatment options, and talked about what might happen if they decide not to proceed. You've done everything you know how to do to help them make an informed decision.

And after all of that, they still choose something you wish they wouldn't.

I don't believe accepting their decision means you suddenly stop worrying about them. How could you? You love this person, you share a life together, and whatever happens to them will affect you too.

But I do believe there comes a point when we have to recognize the difference between helping someone make a decision and trying to make the decision for them.

When an adult understands their medical situation and is capable of making their own decisions, they have the right to accept or refuse treatment. That right doesn't disappear because their spouse, partner, or family disagrees with them.

I know this is easier to understand than it is to live with.

You may find yourself wondering whether you explained your concerns clearly enough or whether there was another question you should have asked the doctor. You might go over the same conversations in your mind, looking for something you could have said differently.

And if their health becomes worse, you may worry that you should have tried harder.

I think we need to be careful about how much responsibility we place on ourselves.

We can help arrange appointments, gather information, ask questions, and encourage someone to consider the doctor's advice. We can tell them how frightened we are and why we hope they'll reconsider. But we cannot take responsibility for a decision that belongs to another adult.

That doesn't mean we have no say in how the decision affects our own lives.

If the person you love declines treatment, you may need to talk about what kind of help they're expecting from you if their health changes. Perhaps you can provide that help. Perhaps some of it will be more than you can manage, especially if you have health concerns or other responsibilities of your own.

I would rather have those conversations while we have time to think about them than wait until we're facing an emergency.

And I believe it's all right to say, with kindness, that you love someone and want to help them, but there are limits to what you can do by yourself.

You don't have to agree with every decision to continue loving and supporting the person who makes it.

Sometimes accepting a decision means living with uncertainty you never wanted. You may still be frightened, disappointed, or even angry. Those feelings don't make you less loving, and they don't mean you've failed as a partner or caregiver.

They mean this decision matters to you, too.

I hope that when we find ourselves in this situation, we can give the person we love the respect to make their own choices while also giving ourselves permission to acknowledge how difficult those choices may be for us.

Section 7: Bringing the Medical Team Into the Conversation

Sometimes, no matter how carefully you try to talk things through at home, you reach a point where you're having the same conversation over and over again. You understand why the doctor recommends a particular treatment, but the person you love still has concerns. And perhaps neither of you feels that the other fully understands what you're trying to say.

This may be a good time to ask the medical team for help.

I don't mean asking the doctor to convince your loved one to do what you think is best. I mean giving both of you an opportunity to talk openly about the concerns that are making the decision so difficult.

When Nasser and I were discussing his prostate cancer treatment, we met with three different doctors to understand the options available to him. We wanted to hear their recommendations, but we also needed to understand how each treatment might affect his life afterward.

Nasser was particularly concerned about incontinence and whether he would still be able to have an erection. Those weren't small concerns to him, and I wanted the doctors to understand how important they were when discussing treatment.

We listened to what each doctor recommended and asked questions about the possible side effects. Having those conversations helped us understand the medical recommendations while keeping Nasser's priorities part of the discussion.

I think that is something we sometimes overlook when we're frightened about a medical decision. We become so focused on whether the person we love will agree to treatment that we forget to ask whether their concerns have been fully addressed.

If someone is refusing a treatment because they're worried about the side effects, I would encourage them to tell the doctor exactly what frightens them. Ask how likely those effects are, whether they might be temporary or permanent, and whether there are other treatments worth considering.

If they're uncertain about the diagnosis or the recommendation, perhaps another medical opinion would help. I don't see anything wrong with wanting to understand your choices before making a decision that could change your life.

And if cost, transportation, or the amount of care needed at home is part of the problem, let the medical team know. A social worker or patient navigator may be able to help identify resources you didn't know were available.

I would also encourage the person you love to tell the doctor what matters most to them, even if their priorities are different from what the doctor expects.

For example, someone may be willing to accept a shorter life rather than undergo a treatment that could seriously affect their independence. Another person may be willing to tolerate considerable side effects for the possibility of more time.

Those are deeply personal decisions. The doctor can explain the medical risks and benefits, but the patient needs an opportunity to explain what those possibilities mean in their own life.

I also want to share something from my own experience as a cancer patient, because I know how overwhelming these conversations can become.

When I met with my surgeon to discuss my cancer, I was so frightened that I finally told him I couldn't talk about it anymore. I had reached the point where I simply couldn't take in another word.

I remember being wheeled into surgery. I had to close my eyes, and I kept repeating the same words to myself: "God, please bless my soul."

I share this because I know what it's like to be the patient who is frightened. Even when you understand why medical care is necessary, there may be moments when you're simply overwhelmed by what is happening to you.

When we're sitting beside someone we love, it's easy to forget how frightening the experience may be for the person who is actually going through it. Sometimes they need more time, or they need the doctor to stop explaining things for a while. And sometimes they just need us to sit beside them without asking another question.

If you're attending the appointment together, I think it's important to agree beforehand about how much help your loved one wants from you. Some people appreciate having their partner ask questions or take notes. Others prefer to speak for themselves and only want someone there to listen.

I would respect that. After all, we're there to support the person receiving care, not to take over the appointment.

There may still be disagreements when you leave the doctor's office. Having more information doesn't guarantee that you'll reach the same conclusion.

But at least you'll have had the opportunity to hear the medical advice, understand each other's concerns, and make sure the decision isn't being made because an important question went unanswered.

And sometimes, even when the final decision isn't the one we hoped for, knowing that the person we love had the information they needed helps us begin to accept it.

Section 8: Understanding What Matters Most to Each of You

Sometimes we think we understand what matters most to the person we love because we've shared a life with them. We know their habits, their worries, and the things they've always considered important.

But when a serious medical decision comes along, we may discover that we're looking at the situation quite differently.

You may be thinking about how much you want them to live and what you're afraid of losing. They may be thinking about the treatment itself, what they'll have to go through, and how their life might change afterward.

I believe it helps to talk about those differences before you're sitting in the doctor's office trying to make a decision.

When Nasser and I first talked about the possibility of prostate cancer, we didn't have a diagnosis yet. But we did talk about what quality of life meant to him. Later, when we had the biopsy results and understood the treatment choices, we returned to that conversation with more information.

Those early discussions helped me understand what he was most concerned about, rather than assuming his priorities were the same as mine.

I've included a worksheet that you and the person you love can use to begin a similar conversation. You don't have to complete it together. In fact, I would encourage each of you to answer the questions separately first.

Then, when you're both ready, sit down and share what you've written.

You may discover that you agree on more than you expected. Or you may find that something you thought was a minor concern is actually very important to the other person.

The purpose isn't to decide who's right. It's to give each of you an opportunity to explain what matters to you and to understand what matters to the other person.

And if you discover that you still disagree, at least you'll have a better understanding of why.

If you would like to have this conversation with someone you love, I've created a worksheet called What Matters Most When Making Medical Decisions?. You can find it in the Relationship & Communication section of my Caregiver Tools Library.

You can each complete it separately and then use your answers to begin a conversation about what matters most to you.

Section 9: When You Still Don't Agree

There may come a time when you've done everything you know how to do. You've talked with the person you love, helped them understand their medical options, encouraged them to ask questions, and offered to go with them to appointments. You've told them why you're worried and what you're afraid might happen.

And they still decide not to follow the medical advice they've been given.

I wish I could tell you there was something else you could say that would change their mind. Sometimes there isn't.

I know how difficult that is to accept because I've lived with the heartbreak of knowing someone I loved needed medical care, and I couldn't make those decisions for him.

My son Stephen died on June 4, 2020. He was 50 years old.

For about two years before his death, I had been concerned about his health. Stephen was overweight, wasn't sleeping well, and had other health concerns. I encouraged him to see his doctors and particularly wanted him evaluated for sleep apnea.

Stephen had always been frightened of doctors and medical procedures, especially having his blood drawn. I knew those fears made getting medical care difficult for him, so I tried to help however I could.

I took him to appointments, asked how things were going, and encouraged him to follow through with additional testing. When we talked afterward, he told me the doctors hadn't found anything significant. I believed he was telling me what he knew.

But the appointments and testing I hoped he would complete kept getting put off.

Then Stephen collapsed at home. He was hospitalized, placed in a medically induced coma, and never recovered.

After his death, I learned something that has stayed with me ever since.

The hospital chaplain told me that Stephen's medical records indicated he knew his heart was becoming damaged and that he needed medical care.

He had never told me.

I have asked myself so many times why he didn't tell me what was happening. He knew I would have helped him. I would have taken him wherever he needed to go, sat beside him through the appointments, and done whatever I reasonably could to help him get the care he needed.

But I didn't know what he knew.

And that is something I have had to learn to live with.

I can't tell you why Stephen chose not to share that information with me. Perhaps he was frightened. Perhaps he believed he had more time. I have thought about those possibilities, but I don't have an answer.

What I do know is that I loved my son, I was worried about him, and I tried for a long time to help him get medical care.

I also know that Stephen was an adult. His medical decisions belonged to him, even when I disagreed with them or feared what might happen.

Accepting that has been one of the hardest things I've ever had to do.

I share Stephen's story because I know some of you are living with that same fear right now. You're watching someone you love make decisions you don't understand, and you're frightened about what those decisions could mean for their future.

I would encourage you to keep the door open for conversation. Let them know you're willing to listen, even when you disagree. Offer to help them get information or speak with another doctor if they're willing. And if they don't want your help, you can still tell them you love them and that you're there if they change their mind.

But I also want you to think about what this is doing to you.

Living with constant worry takes a toll. You may find yourself thinking about their health when you wake up, when you're trying to sleep, or whenever they mention another symptom. You may be afraid to bring up the subject because you don't want another disagreement, yet feel guilty when you say nothing.

Please don't feel that you have to carry all of that alone. Talk with someone you trust. If the worry is affecting your own health, consider speaking with a counselor or another professional who can help you work through what you're experiencing.

And remember that respecting someone's decision doesn't mean you have to take on every responsibility that may follow from it. You can be honest about the care you're able to provide and the help you would need from others.

I still wish Stephen had told me what was happening with his heart. I wish we could have had those conversations while there was time to explore his options.

There are questions I will probably never have answers to.

But I also have to remember that I did everything I could with the information I had.

If you're facing a similar situation, I hope you'll remember that you can love someone deeply, disagree with their medical decisions, and still respect their right to make them.

Accepting their decision doesn't mean you believe it was the right one. It means recognizing that, however much you love them, you cannot make that choice for them.

Section 10: Loving Someone Doesn't Mean You Can Make Their Choices

If you've stayed with me through this conversation, I hope you've come away understanding that there isn't always an answer that makes everyone comfortable.

You may have a good relationship with the person you love. You may talk openly, respect each other's opinions, and usually find a way to work through your differences. But when a serious medical decision comes along, you may discover that this is one disagreement you cannot resolve together.

I know how frightening that can be, particularly when you believe their decision could affect how much time you have left together.

I would encourage you to keep talking with each other, as long as those conversations are welcome. Ask what matters most to them and listen to their concerns. Help them find reliable medical information, encourage them to ask questions, and make sure they know you're willing to help.

But I also want you to understand that there may come a point when you've done everything you reasonably can.

You may have to accept a decision you would never have made for yourself.

And I don't want you to confuse acceptance with agreement.

I can accept that Nasser has the right to make his own medical decisions while still worrying about the choices he makes. I can tell him how I feel, offer whatever help he wants from me, and be there beside him as we face whatever comes next.

But I cannot promise that I will always agree with him, and I wouldn't expect him to agree with every decision I make about my own health.

That's part of being two people who love each other but still have the right to make choices about our own lives.

I also hope you'll remember to take care of yourself through all of this. Your feelings matter, too. You shouldn't have to pretend you're comfortable with a decision when you're frightened about what it may mean for your future.

Find someone you can talk with honestly, particularly if the disagreement is beginning to affect your relationship or your own well-being.

And if the person you love eventually changes their mind or asks for help, I hope you'll be able to meet them where they are, without reminding them of all the times you tried to convince them.

I've lived long enough to know that we don't always get the answers we want, and sometimes we don't get answers at all.

What I hope for you is that, whatever decisions lie ahead, you and the person you love can continue to treat each other with kindness and respect.

You can stand beside someone, love them with all your heart, and still wish they had made a different choice.

Research Reference

Taber, J. M., Leyva, B., & Persoskie, A. (2015). Why do people avoid medical care? A qualitative study using national data. Journal of General Internal Medicine, 30(3), 290–297.

https://doi.org/10.1007/s11606-014-3089-1

Dedicated to the memory of my son, Stephen, who died on June 4, 2020, at the age of 50.

With all my love, and for the questions I will never have answers to.