There has been a lot of fear mongering over the last year about end of life issues. To hear some politicos tell it there is a proposed change that would go something like:
-Granny, you have had a good life, but we ran a cost/benefit analysis and you are no long cost productive so the doctor is here to talk about transitioning you out….
To set the record straight, I know of no health care reform proposals that will kill your grandmother. All joking aside, I welcome the renewed focus that the legal issues surrounding end of life and critical care issues are receiving. Decisions as important as what care you receive at the end of your life should not be made in a place of anxiety or fear. The time to prepare is now before the need arises.
Most states, including Texas have an advance directive law. This Texas law was passed in 1999 with broad bipartisan support. I usually include living wills, also called advanced directives, in all of my estate planning packages. The advanced directive is an important part of any estate plan. When used in conjunction with other documents the advanced directive provides control over end of life issues.
In the standard advanced directive you decide what care you want if you are incapacitated and unable to speak for yourself. Do you want to be kept alive with respirators even if the doctor thinks there is no hope of recovery or do you want to be allowed to die as gently as possible? You decide and record your wishes now, before you need it. Most of us have never had this discussion with friends and family. It is hard to imaging slipping a discussion like this into casual conversation over Sunday lunch or a night out with friends.
“Mom, can you pass the hot sauce. Oh and by the way…if, in the judgment of my physician, I am suffering with a terminal condition from which I am expected to die within six months, even with available life-sustaining treatment provided in accordance with prevailing standards of medical care I want you to a) make sure that all treatments other than those needed to keep me comfortable be discontinued or withheld and my physician allow me to die as gently as possible; or b) make sure that I be kept alive in this terminal condition using available life-sustaining treatment. ”
We just don’t like to talk about these things. Unfortunately, if the need were to arise suddenly, as it often does, there would likely be conflicting ideas about what you wanted. I spoke to a young man at the Urban Harvest Farmers Market yesterday, who told me that he was sure his family would ignore his stated wishes if he were in a terminal condition. (This is of course what family does: They generally know better, or think they do, than we do.) By creating this document now, and having this conversation with friends and family now, you can ensure that you will receive the care you want.
Once you have executed this document, you will want to give copies to your healthcare providers and ensure that friends and family are aware of its contents. In the midst of a difficult time, this simple act can provide some peace and control for you and your family. Rosy and Lulu at the Farmer’s Market
