Questions about Advance Directive (spouse, father-in-law, inheritance, relative)
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My wife, her sister and I were standing around her mother's hospital bed. She had an AD which said no "artificial means" and she was unresponsive and on a ventilator with very low blood oxygen levels. We actually grilled her (aggressive questioning, not the backyard cooker) for several minutes about if she wanted us to pull the plug. Finally, she moaned something we all took to be "no." She went on to live for several more years.
The point of this story is have people you trust in charge who can make judgments about the severity of your situation and your truest desires. If you're in dire straits, then let go; if not, let's hold on a while longer. The document alone cannot be the decision-maker, because as has been pointed out, there are too many variables to for an iron-clad document to cover them all. As long as you don't end up withering for years with no hope of recovering and draining your family's finance because you have no document at all.
Now the withholding of food- that's a real bugaboo. Really tough call. Would you really want your loved one to starve to death? Maybe, depending on the prognosis and their level of consciousness..
Advance Directives do not have to be followed by medical professionals. Well, yes, they do, and, no, they don't. There are both federal laws and state laws covering Advance Directives, and it's all somewhat complex.
A doctor, who thinks that the patient has a good chance of recovery, given enough treatment and time, will not pull the plug, no matter what our AD and/or loved ones say.
Not all that long ago, there was a news story carried by a major news station. I don't know how true it is. HOWEVER,
A man had "DNR/DNI" (do not resuscitate/do not intubate) tattooed on this chest. He thought that, should he become unconscious in his home, the EMTs would know exactly what to do. But, again, there is law: EMTs are not allowed to just let a patient die. EMTs must do everything they can possibly do to get the patient to the hospital, alive. If a patient does die enroute to the hospital, an EMT can't even call time of death. Only a physician can do that.
Advance Directives do not have to be followed by medical professionals. Well, yes, they do, and, no, they don't. There are both federal laws and state laws covering Advance Directives, and it's all somewhat complex.
A doctor, who thinks that the patient has a good chance of recovery, given enough treatment and time, will not pull the plug, no matter what our AD and/or loved ones say.
Something to think about.
Well, I don’t want them to if there’s a good chance of my recovering LOL. That’s one of the things I worry about, that they’ll pull it too soon especially if I’m an organ donor.
As someone who recently watched her once strong, vibrant elderly father become sicker and weaker over the course of a year (and who had previously issued a DNR order), in extreme discomfort the last few weeks controlled only with morphine, I can tell you that to revive a terminally ill person as they are at the threshold of death (assuming it would even be possible), only to perhaps last and suffer another week or so, would be the most CRUEL thing I can imagine. I am so thankful that DNR orders exist, and pray that children (or whoever is overseeing the care) honor them.
From my experiences over the last 10 years (and 4 deaths) with this: for the most part, your Advanced Directive is ignored by emergency personnel (their job is to get you, still alive, to the hospital, not to waste time running down paperwork) and often hospital personnel as well.
The only thing that is absolute is: a POLST (or MOLST, called various things in various states) order, which is essentially a DNR with a doctor's signature on it to give it enough weight to medical personnel. These are generally only issued for very ill or terminally ill people in hospitals/hospice. The other thing hospitals listen to is the patient's advocate, IF the advocate happens to be on site at that moment AND has medical power of attorney.
The most troubling issue I had during my father's illness was that his Advanced Directive was filled out when he was still very active. He knew he had a degenerative disease which would soon limit him, and he wanted no medical intervention of any kind.
BUT as he gradually grew weaker and sicker, he still had things he took pleasure in. So twice I allowed medical intervention that he had specifically declined - the first time he did indeed get better (although "recovery" was never an option) and he went on to be able to watch his all-important World Series, albeit from a wheelchair or hospital bed. The second time I allowed the intervention (intubation and a feeding tube), it was obvious after 48 hours that it was not helping. I spoke to the several people at the hospital, who resisted removing "life-saving" medical equipment and was on the point of bringing in an attorney to enforce my wishes when he died anyway. But I would NOT have let him linger in that state, as I knew he wouldn't have wanted to.
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As someone who recently watched her once strong, vibrant elderly father become sicker and weaker over the course of a year (and who had previously issued a DNR order), in extreme discomfort the last few weeks controlled only with morphine, I can tell you that to revive a terminally ill person as they are at the threshold of death (assuming it would even be possible), only to perhaps last and suffer another week or so, would be the most CRUEL thing I can imagine. I am so thankful that DNR orders exist, and pray that children (or whoever is overseeing the care) honor them.
I am so very sorry that your father suffered and you suffered with him.
No, medical personnel would never do that.
This is a perfect example of why I support P-A Suicide.
From my experiences over the last 10 years (and 4 deaths) with this: for the most part, your Advanced Directive is ignored by emergency personnel (their job is to get you, still alive, to the hospital, not to waste time running down paperwork) and often hospital personnel as well.
The only thing that is absolute is: a POLST (or MOLST, called various things in various states) order, which is essentially a DNR with a doctor's signature on it to give it enough weight to medical personnel. These are generally only issued for very ill or terminally ill people in hospitals/hospice. The other thing hospitals listen to is the patient's advocate, IF the advocate happens to be on site at that moment AND has medical power of attorney.
The most troubling issue I had during my father's illness was that his Advanced Directive was filled out when he was still very active. He knew he had a degenerative disease which would soon limit him, and he wanted no medical intervention of any kind.
BUT as he gradually grew weaker and sicker, he still had things he took pleasure in. So twice I allowed medical intervention that he had specifically declined - the first time he did indeed get better (although "recovery" was never an option) and he went on to be able to watch his all-important World Series, albeit from a wheelchair or hospital bed. The second time I allowed the intervention (intubation and a feeding tube), it was obvious after 48 hours that it was not helping. I spoke to the several people at the hospital, who resisted removing "life-saving" medical equipment and was on the point of bringing in an attorney to enforce my wishes when he died anyway. But I would NOT have let him linger in that state, as I knew he wouldn't have wanted to.
I am so very sorry that you had to go through that.
I am so very sorry that your father suffered and you suffered with him.
No, medical personnel would never do that.
This is a perfect example of why I support P-A Suicide.
In working in nursing homes we’ve had people who were revived after too long a time and were saved but non-responsive. They’d exist in a nursing home bed and really no matter how often we ranged and turned them, they inevitably become contracted and develop wounds. They can exist for years, decades like that. There are women who stand out in my mind as the saddest cases, both sustained brain injuries as children/teens, one a car accident and one a dental anesthesia error. Both had been there being kept alive on feeding tubes for many years.
But it’s hard to say in the moment, “don’t keep my child alive”.
Wow! So would you just skip that part and then try to change it if you had a terminal illness? Or check it, and then write in the additional instructions that it only applies in the case of a terminal illness?
As I suggested before, you can and should revisit your directive if your health circumstances change. We have tools available...they aren't perfect, which is why you have to take steps to make sure others understand and will honor what you want. That includes your doctor(s) and the hospital you are most likely to end up a patient in.
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