No

by Amanda Banning

Created on: December 24, 2010

While most people tend to think that tragic or catastrophic events will never happen to them, invariably the reality of being wrong catches us unprepared. Since we tend to believe in happy endings, we tend to think we will never actually need to plan for such a possibility of not being capable to verbalize our own wishes and directives.

Everyday, someone’s life takes such a turn and the responsibility of life altering choices falls upon family or friends. It is possible that there will be a happy ending, but many times, even if for a short time, the situation becomes tumultuous and overwhelming for those who inherit, by default, the need to make life choices and difficult decisions for another.

While most healthy and mentally alert people assume their personal directives will be honored in times of crisis or uncertainty, there will be those whose fate will be argued by others who are primarily considering their own best interest, Sadly, not all such decisions are made with the best interest of the person in question. We do not anticipate not being capable of making our own decisions or the reaction and agenda of those who will be making those decisions. We tell our family what our personal wishes are, yet we do not always document our choices. This is where the situation can turn terribly awry.

As a retired medical provider, I have seen families come to physical blows over the decisions being made on a loved one’s behalf. Only the person with legal Durable Power of Attorney will be heard by the medical staff and recognized as the designated legal guardian for the patient. It is not wise to assume all family members will agree with all of the decisions made by the guardian. It is also important to understand the decisions involved are not going to be perceived as cut and dry by others. Many times wild accusations and intense emotions prevail.

Certainly, one would expect his wishes be honored if he has prepared his wishes and put his choices in writing. It is very hard to argue with words written in the patients own hand. The wishes are clear and the choice of guardian is already decided. When the person has not completed a Living Will or a Durable Power of Attorney, the family is forced to collectively decide what the patient’s wishes would be. This could result in decisions angrily being made in haste which not reflect the patient’s wishes.

An even more difficult situation occurs when the individual is conscious, but deemed mentally unstable. Because the level of impairment may be debatable, at what point do you no longer consider or respect the wishes of the person? It could be chaos if the patient is demanding the right to refuse certain treatment or to completely refuse medical care. Perhaps the person knows of the probability of impending death and has decided treatment would be futile, but the family feels differently.  If a patient has decided not to utilize feeding tubes and ventilators because it will only extend his suffering and end his life, is that dignity to be removed by feuding family members who want to squeeze another week or month of life for them? Presumably, this is why the patient considered the living will or Durable Power to begin with, and it should be honored as the patients wishes.

The wishes of the family should never take precedence over the wishes of the individual as long as the individual has verbalized his choices, completed a living will and is willing to appoint a Durable Power of Attorney if he or she cannot speak for themselves.  We expect our wishes to be honored and we should give others the same courtesy and compassion. If the patient has a psychiatric history, be sure to medically document the time these choices are made and that the Physicians involved in all aspects of care agree this person is of sound mind at the time this paperwork is completed and notarized

Everyone has a right to live as he wants and to make life changing decisions about his own care if he chooses to do so. To stop family objections, the family needs to be told what decisions, both extreme and routine, that is preferred. Uncertainty breeds confusion and confusion breeds conflict. We owe it to our family to have those choices made and on file at the local hospitals before we need them. Clear and final decisions can be part of the gift of clarity a loved one leaves behind.

Learn more about this author, Amanda Banning.
Click here to send this author comments or questions.