End-of-life Issues
November 7, 2004
The Conway Daily Sun
Dr. Brian Irwin
Few things are more unnatural than talking about the end of one's life. It is
a very uncomfortable topic to discuss with your partner, children, family and sometimes
even your health-care provider. Many patients feel that discussing the issue signifies
a motivational surrender; that to talk about the end means that you're ready for
the end. This is a normal reaction. Although not everybody shies away from the topic,
enough people (both patients and providers) do that these important issues are often
neglected until a patient is critically ill, forcing families to speculate about
their loved ones wishes and making very difficult decisions in time of great stress.
The issues of power of attorney and living wills are such emotionally-charged
topics that they often become the topics of sensationalist media productions, like
20/20 documentaries or made-for-TV movies. This media exposure only heightens the
public sensitivity of these topics, escalating the "am I doing the right thing?"
introspection that is stressful enough for families without the lingering thoughts
family conflict and ethics.
I once cared for a woman who had been on a ventilator for two years. In that
time she had no appreciable physical movement, mental awareness or change in status.
Her family was split evenly regarding the issue of withdrawing care. And so it went
for years, family arguing daily, over her body in her hospital bed, as to whether
or not "mom would have wanted this." Of all the things the family pondered, the
foremost was, "What would mom want?" Unfortunately, prior to her admission, no one
had ever asked mom.
In many cases these decisions are hard to make. It's nearly inconceivable to
try to imagine how aggressively you would want someone to treat you in a terminal
situation if you are a healthy person who has never been in or near that situation.
In some cases a chronic disease burdens a patient and his or her family for months
or years, but the availability of a rough prognosis allows the family to talk, plan
and make decisions. Most of the time, however, an accurate prognosis is difficult
or even impossible to make. In these cases, having discussed one's wishes and desires
can make all the difference between a family's stressful scramble for ethics and
quiet, comforting time to be with a loved one as they pass away.
There is a lot of confusion surrounding certain issues in end of life care. Patients
often feel that when they sign a living will, they must make an all-or-none decision.
This isn't true. One's living will can be as elaborate as they wish, specifying
exactly what interventions they do and don't want.
Another common misconception is that this document stands over all else. Not
true. What stands is the patient's wishes. Patients can change their minds, their
documents or both at any time, should the situation change.
The most important aspect of long-term planning for one's health issues is open
communication. Talk with your friends. Talk with your family. Talk with your health-care
provider. Make your concerns, wishes and plans known. Consider signing a living
will. By broaching this topic early, much of the guessing and assuming that ends
up playing a role in decision-making can be avoided. By communicating with those
who care about you today, you have the power to make sure your medical care is managed
in just the way you wish, hopefully allowing you, your friends and families to relax
and enjoy each other tomorrow.
Créez votre testament, votre procuration et votre testament de vie sur
https://www.legalwills.ca/fr/.
Pour plus d'informations, contactez :
LegalWills.ca
Courriel :
[email protected]
Internet :
https://www.legalwills.ca/fr/