Answering the "What
If" Questions: Advanced Directives
Last week I discussed
several legal cases that established the need for Advance Directives -
documents that dictate what medical interventions you want undertaken should
something horrible happen to you. These
cases all involved relatively young and healthy people who had no written
statements made about their end-of-life wishes.
The two legal advance
directive documents are called a Living Will and a Durable Power of Attorney
for Health Care. These have grown out of
the need and desire to maintain individual control over one's life by extending
your right to choose future health care interventions. Any competent adult can have a set of advance
directives and they are legally-binding documents.
The Living Will is a
document directing doctors to withhold or withdraw certain treatments that
could prolong the dying process. These
treatments may include CPR (chest compressions and electric shocks to restart
your heart), insertion of a breathing tube so a ventilator can breathe for you,
artificial nutrition through a feeding tube or IV, dialysis if your kidneys
fail, or blood transfusions. You can
specifically state what things you would or would not want performed, including
things like pain medications to keep you comfortable and free of pain, even if
it means you are less alert to your surroundings.
The Durable Power of
Attorney for Health Care is a document that lets you name an agent, or someone who can act for you
and make health care decisions when you are unable to. This agent is typically a spouse, an adult
child, or a close friend. They are supposed
to base their decisions on what you tell them you would want, or what they
think you would choose, so it's important that your agent knows your
preferences ahead of time before anything happens.
Many hospitals have information packets available to help you construct
your advance directives, or your attorney can handle the process. There are also numerous online
resources. The documents need to be
witnessed or notarized.
Perhaps the most important take-away message here is to communicate with
your friends and family members.
Discussing tragedy and death is not an easy conversation, but people
need to know what you would want done should something horrible happen. This is especially important for young and
healthy people like those in the legal cases, as unforeseeable calamities are
unfortunately a part of life.
*** Dr. Matthew Bogard, Iowa doctor, is an emergency medicine doctor primarily at the Lucas County Health Center in Chariton, Iowa. Presently, he is Board Certified in Family Medicine by the National Board of Physicians and Surgeons and the American Academy of Family Physicians.
