March 15, 2005

advanced directives

Terry Shiavo hasbeen the tiopic of conversation on several different pages and blogs of late. Tehre are even sites devoted to the current crisis about her health care. I have avoided the fray for several reasons, but now I think I will chime in with a thought or two.

Much of the rukus could have been avoided had Terry and her family sat down and spoken about end of life care and had established a power of attorney for medical care. An "Advanced directive" is simply a formal statement of the patient's desires and wishes should life saving/prolonging treatments be necessary. At the hospital whetre I workm as consistant with the state of Illinois, we have forms available so patients and families can state their wishes before a patient undergoes treatment (emergency surgery, scheduled procedures etc). This is a great thing. Sometimes patients take advantage of this. Most often they don't. There are several reasons for either choice, but my suggesti8on is that if you wish tpo prevent the legal and media circus that Terry's family is suffering through, then fill out one of those forms. Do it now. Talk to your family. Speak with your doctor. Get a lawyer to help you out if that makes you feel better. This way you (the patient) can have your wishes and desires known. You protect yourself from the state if that is your desire. You protect yourself from beeping machines in the hospital if that is your desire. You can in this way preserve your religious, ethical and moral beliefs.

The paperwork is consistant with the separation of church and state, the medical oaths that doctors and nurses take, and preserves the autonomy of the patient. The reminder that the Shiavo case provides is how few people take this step and how devestating it can be if we do not. FILL OUT THE PAPERWORK. It may be that even the conversation is not enough. Choose your agent carefully. It does not even have to be your enxt of kin. You can choose your priest of the neighbor if they are so willing. Just sit down and do it.

Posted by tripp at March 15, 2005 09:26 AM | TrackBack
Comments

We learned this when my dad was basically on his deathbed. We had always planned to do it, but then my dad had his heart attack, and no papers were signed. Luckily he was cognizant engough during those last 24 hours that when we asked our lawyer to stop by he was able to express his wishes and sign the appropiate papers. His wish was fulfilled. The day after his funeral, mom, my bro, and I all went and signed papers for ourselves.

I am seconding your emphasis here...SIGN THE PAPERS. Not only to avoid all of the legal problems that come with the prolonging of life by machine, but most importantly it helps greatly with closure knowing that you have fulfilled the wishes of your loved one.

Posted by: justin at March 15, 2005 10:07 AM

Tripp, I know that you were likely being quick in your writing and trying to make an amusing suggestion, but I really don't think that you should choose your priest. Or, more to the point, if you are clergy, I don't think that you should agree to be someone's heath care proxy.

It seems to me that the conflict of interest (especially if you are also the spiritual caregiver of other members of the family) would speak against such a selection.

In fact, I would be very careful as a member of the clergy about even witnessing a legal document for a member of your parish. If there is a competency hearing, a contesting of the signature, or other legal proceeding, you could find yourself in a sticky situation--pastorally, if not canonically, and secular-legally.

I did it all the time in the hospital, as I imagine you do, but there I was not in relationships with the rest of the family.

That said, Tripp, you are right about advanced directives. They are so, so important. We should all have them right now. One other important lesson of the Terry Schiavo case is that it is not sufficient to rely on the state-mandated order of succession in heath care proxy cases. It is more important than ever to clearly state your preferences as to who should be making decisions in case you can not.

Even your priest is better than nobody.

Posted by: Micah Jackson at March 15, 2005 10:16 AM
Even your priest is better than nobody.
Yeah, that and humor was the point. There could be a conflict, but if you want to make very certain that all of teh religious hops are jumped through, then having a religious authority in the process makes sense. Signing my be problematic, but there you have it.

As chaplain, I witness a great many of these. That would be a great place for the priest/pastor/minister to enter in the conversation.

Posted by: Tripp at March 15, 2005 10:49 AM