One of the great mindbenders of our lives is End of Life directives.
Here’s a list of where directives go haywire:
- unclear language in the document
- document “enforced” by someone other than the subject of the document
- document not present during decision making
- assumptions and pre conditions by family, self, doctors
- written policies surround use of dnr
- unwritten policies
- spur of the moment context/second guessing
- diagnosis of what’s really End of Life
- lack of directive standards
- and so on…
It really bends my mind to consider that one of the most final decisions we can make about ourselves or family members is this damn gray. in previous posts I talk about the data collection and precision targeting of our world, and yet, with directives we bring NONE of that approach.
Directives are a terrible information device – at this time. What can we do to clear them up? what can we do with the context surrounding them? is it just a matter of experience – the more we interact with them the more precise and effective they become?
things that make you go… hmmm… argh… help!?
Check this site out for tons of cool analysis and concepts. http://www.eperc.mcw.edu/ff_index.htm
~Russ
DNR, Health Care Directive, Health Care Proxy, Living Will, whatever you call it, it’s not the document that’s the problem (which is not to say the documents aren’t problematic) — but the documents, and the gray areas they contain, are merely symptoms.
The problem is really our society’s inability to talk about one of the very few things that all of us will experience no matter what – DEATH.
Now, I’m not a parent, and I was raised in a secular family, so my perspective may not speak to many people, but I have turned off the machines keeping more than one of my relatives “alive” (including my 62-year-old father) so I do know a thing or two about these situations.
My father did not have a health care directive or any papers that spoke to this issue aside from a document naming me power of attorney. What he did have however was open communication about difficult issues with his family. There was never any doubt in any of our minds how he felt about feeding tubes and the like. He had made it clear on a number of occasions that life support was not for him.
Now, without a document to this effect we still could have been in trouble if either my brother or I got “cold feet” about it or if we had been in a different hospital or with different doctors, but luckily that was not the case for us. It also could have been a problem if either my brother or I decided to put our own feelings ahead of my father’s wishes. We were even luckier that that wasn’t the case. I’m not going to say the emotions surrounding those 24- hours were not difficult, they were, but as my brother pointed out, we weren’t making a decision, we were carrying out my father’s wishes. And there was a great deal of solace in that.
Everyone reading this has the ability to give their loved ones this kind of solace by having a very difficult conversation and writing it down. That doesn’t address the issues of the gray areas that the documents create, but if people truly know what is important to their loved ones the gray areas can be overcome.