Ethics and the Advance Directive

The frail, elderly patient was so pale as to be nearly invisible against the crisp white sheets.  Any ability to give voice to his thoughts had been taken away by the ventilator tubes in his throat.  The soft restraints on his wrists prevented him from dislodging those tubes, either in confusion or by design.  Other tubes silently pumped fluids in or drained them out.  During his lucid moments he wondered how it had come to this…

I sit on the Ethics Committee at my hospital; it is a group that deals with complex, challenging and sometimes heartbreaking dilemmas. Participants need a knowledge of state and federal law, an understanding of the essential workings of the healthcare system, and perhaps most importantly, wisdom and compassion. We are fortunate to be led by a physician who excels in those abilities.

As we reviewed cases during our most recent meeting, an obvious theme began to appear. Many of the ethics consults centered around patients with dimminished capacity for decision making who had no one appointed or available to speak for them.   In those cases, providers often turn to the Ethics Committee for guidance, particularly when dealing with end-of-life decisions.

It was a powerful reminder that each of us needs to document our wishes, particularly those regarding end-of-life care, and appoint a trusted individual as our Healthcare Agent/Power of Attorney. Doing so can ensure that our wishes are met and can also relieve our family members of the stress of having to make difficult decisions for us.

Free forms are available. Caring Connections provides links to download many State documents.

Complete one and carry it with you.  Make sure that your physician and your “healthcare attorney in fact” also have copies.

Don’t leave your future up to a room of well-intentioned strangers. 

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