About Advanced Directives

I want to buy your house – trust me!

This is a controversial subject, so be warned. I am not writing this to upset people, just to focus attention on an important issue.

We have never advised our clients to execute Advanced Directives (AKA Living Wills). Our involvement in the Terri Schiavo case has caused us to talk to a great many doctors and nurses about those complicated issues.

An Advanced Directive makes a lengthy list of decisions about specific medical treatments, long before any of the issues present themselves, very much in a vacuum. Our point is that it is impossible to anticipate all the permutations of events and circumstances that may come together, and when they do, it will be at the worst time of your (or your loved one’s) life.

Now America is confronted with the Covid-19 virus, and a basic fact is that a great many hospitalized patients wind up in intensive care. Many of those are put on ventilators to help them breath.

But Advanced Directives often state that patients will NOT be put on ventilators. I think most people don’t think about their temporary use, such as in treating a collapsed lung, or this pandemic. But, if applied across the board, it means that all of those patients would just die, without doing everything that can be done to help them recover.

I have tried to find out how many such patients survive, but there don’t seem to be reliable statistics, at least not yet. We see patients on television nearly every day, getting discharged from hospitals after being on ventilators.

There is a better way to deal with these (“end of life”) issues, and that is with a Designation of Health Care Surrogate. It involves selecting the person who knows you best, your attitudes, beliefs, and feelings regarding how such important decisions should be made. It should be someone strong, who can deal up-front with medical professionals, again, on the worst day of your life. And it would not necessarily be a spouse, as spouses are not always the most trusted person in your life.
That surrogate should first, find out the facts. What is the real story about your situation, treatment options, and likely outcomes? That person may need to demand a second opinion. And he or she will have to be trusted with the ultimate decision of whether you live or die, instead of someone who is a stranger to you.

It’s a tall order, but we believe, the best way to handle that delicate situation.

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