“What would Joanna have wanted?” the ICU fellow (Dr. Smith) asked Sam, Joanna’s nephew and health care proxy, for the second time this week. Sam considered the question, furrowed his brow, and said, “I still don’t know, doc.”

The human costs of indecision.

Uncertainty can at times be better than false certainty. This may even be so, up to a point, when a loved one is on life-support and subject to invasive and painful procedures. It takes time to absorb the reality of a situation.

But any nurse can tell you that, at some point, indecision becomes a decision in itself, one that can lead to many unwished-for consequences.

Seemingly unanswerable questions.It

The quotation at the start of this post is from this month’s Reflections essay, “What Joanna Would Have Wanted” (free until July 15). The story, by nurse Jennifer Chicca, MS, RN, evokes the overwhelming sense of responsibility faced by a thoughtful young man in the role of health care proxy to a beloved aunt.

How is possible to be sure what someone would want, or not want, when their end-of-life wishes have not been clearly spelled out ahead of time?

‘Discover their answers.’

In some cases, we may find the answer by listening. Writes Chicca:

“Get to know patients’ former selves. Ask different questions. Discover their answers.”

She gently encourages the nephew to put aside the anxiety and distress of the moment and to listen inwardly, to allow the vibrant aunt he knew to come into focus again in his memory and speak her final truth—which is perhaps the truth of who she always was.

That nagging question: What do you want? We can dodge it or embrace it all our lives, but at the end it may still be there, waiting for someone to answer. Nurses are often there to bear witness, or to help family members find their way to an answer of their own.