Table 3.

Palliative care principles and advance care planning codes and representative examples from recorded dialogue.

Code	Example
Palliative care principles
Palliative care consultation	“We will have the Quality of Life team come here, we are going to optimize her pain meds.”
Quality of life	“So, to see you living life a hundred percent, with your arms wipe open, climbing up trees and climbing on granite and really getting out in the middle of the night…Like, holy moly, that is living!”
Goals of care	“It’s all about what your goals are, obviously. Our goals are for him to be with us for as long as possible, but the more this comes back and the more treatment he’s had, it makes it very hard for us to make this go away and stay away…So, it’s a matter of what your goals are for him.”
Comfort	“As long as she’s not in pain and as long as she’s doing okay, we are going to do our very best to keep her free of pain and as comfortable as possible.”
Palliative chemotherapy	“There are probable other oral chemotherapies that we could try, again, the same goal would be to kind of stabilize the disease. We don’t know necessarily the effects of them, or, but it would be more kind of try to prolong things as long as possible.”
Limited toxicities	“There’s oral medicines we can try and it doesn’t mean they’re less effective or less powerful, they’re just less toxic.”
Palliative radiation	“If you decide that the pain has gotten out of hand, that you would like to consider additional radiation to some sites, that’s what we’re here for.”
Advance care planning
Invasive procedures	“If we did a bone marrow [biopsy], maybe she would have disease there or not, I don’t want to put her through a bone marrow, because I don’t want her to hurt after a bone marrow, and given the findings that we have on the scans, it’s irrelevant.”
Intubation	“If she were to stop breathing, or, if she were to have a seizure that you cannot control. Do you go to the emergency room? Do you put a tube down her throat to help her breathe?”
Cardiac resuscitation	“If her heart stops, if this lesion is there, the heart stops do you start pumping the heart? Do you start giving medicines to bring that back? Or do you just make her as comfortable as possible, and not put her through all of that?”