We strongly recommend reading and discussing the full article archived on the NY Times website with your family.
What do you do when last minute opinions are different from those expressed over many years? At the end of theonline article there is a button that includes the advice and experiences of over 260 professionals in end of life care. These are even more valuable than the article.
…The time had come to clarify what types of interventions my father wanted. I knew what I hoped to hear. Not only did I know his opinions about inappropriate treatment, but he had written some notes when he began to seriously deteriorate. He said that he was “taking steps to ease my passage.” Some with his condition, he added, “have taken drugs.” Regarding his wife — my mother — he wrote that she “doesn’t deserve to struggle with me anymore.”
But when I asked what he wanted, these notions had disappeared. He said he would be willing to go to the hospital if he got sicker and even go on a ventilator. “Sometimes they can really help,” he said.
I tried a different tack. “Are you content,” I asked, “living in a nursing home, being confined to a wheelchair and sleeping most of the time?”
The man who had dreaded ever winding up this way answered, “Yes.”
My father’s change of mind was hardly unprecedented. With the rise of living wills and health care proxies, people now often indicate how they want to limit medical interventions if they reach a state of irreversible infirmity. Although such documents are intended to take effect when serious illness clouds judgment, bioethicists such as the Washington University professor Rebecca Dresser have compellingly written that people’s goals may genuinely change when they confront a lessened quality of life and their potential death. As a result, she argues, a patient’s “experiential interests” at this later time should take precedence over the earlier wishes.
In my father’s case, however, I simply could not throw his previously stated wishes out the window. Ultimately, my mother, sister and I concluded that it was impossible to advocate such specific choices so fervently in one’s lifetime without their being a part of one’s permanent makeup — even if they could no longer be articulated. I realized that other families, in similar situations, might choose the opposite strategy…
Barron H. Lerner, a professor of medicine and population health at the New York University School of Medicine, is the author, most recently, of “The Good Doctor: A Father, a Son, and the Evolution of Medical Ethics.”
Having decision makers discuss a calm and reasoned plan for possible outcomes greatly helps improve end of life experiences and memories for the extended family.
Heartfelt Memorial Services: Your Guide for Planning Meaningful Funerals, Celebrations of Life and Times of Remembrance.
Dave Savage and Beverly Molander HeartfeltMemorialServices.com Get it at Createspace.com/5070036