End-of-life discussions for the primary care obstetrician/gynecologist

This review of end-of-life decisions centers on the role of the obstetrician/gynecologist in assisting women patients to develop advanced directives that are targeted to unique risks of the pregnant woman; these risks are related to trauma, cancer, and aging; to the special need for lesbian couples to identify health proxies; and to the woman's responsibilities as a caregiver to ensure advance directives and medical proxies for the family. End-of-life decisions are much more stressful when surrogate decision makers do not know in advance what decisions a patient would want made if the patient becomes incapacitated.