Monday, October 15, 2007

"I don't want to go on the cart!"

"Back off! I'm Not Dead Yet"--an article on living wills and advance directives at the Washington Post by Charlotte F. Allen (If my link does not work, try the one at Real Choice) Her article begins with her short battle with breast cancer, and her experiences with the paperwork that comes with risky (yet often life-saving) medical treatments.

Having recently been seriously ill enough to be in the hospital--and asked questions about advanced directives--and having had two of my relatives diagnosed with cancer in the past 6 months, and the oldest living member of my family now receiving hospice care, this article really hit home for me.

Here's a small excerpt:

...I found something weasely in the way all those options were presented, as though my only real choice were between being dispatched into the hereafter at the first sign of loss of consciousness or being stuck with as many tubes as needles in a voodoo doll and imprisoned inside a ventilator until global warming melts the ice caps and the hospital washes out to sea. I found the box on the form that said "I decline a living will" and checked it. Right now, my husband is my living will, and after we spent 13 days observing Terri Schiavo exercise her "right to die" by being slowly dehydrated to death after her feeding tube was removed in 2005, he knows exactly how I feel about such matters.


it seems that people talk a good game about living wills, especially when they're healthy, but when their health begins to fail, they often have very different ideas about what they would be willing to undergo to stave off death for a little while. Furthermore, according to a 1990s study by the National Institutes of Health, even when patients have living wills, if those wills contain directives with which doctors and hospitals disagree (such as, I myself suspect, prolonging the patient's life instead of terminating it), many doctors simply ignore the patient's desires. Living wills, it would seem, are effective only if they happen to comport with doctors' and bioethicists' own theories about what is best for the patient anyway. For this reason, the authors of the Hastings study propose that instead of filling out a living will, people execute a durable power of attorney, a simple document that entrusts decisions about end-of-life care to a relative or friend who shares the signer's moral beliefs about death and dying. That sounds about right to me.

None of us should be tossed on the cart before it's time.

Hat tip: Christina Dunigan

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