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There are two types of Advanced Medical Directive. These are called (1) living wills and / or (2) a durable power of attorney. Although both are advanced directives they are very different legal documents.
A living will is a set of written instructions that explains your wishes on the matter of health care in an emergency or terminal condition. These are referred to as ‘living wills’ because they are actually in effect while the patient is still alive. You are able to make decisions, in advance, about such serious matters as cardiopulmonary resuscitation (CPR), Intravenous Therapy (IV), Feeding Tubes, Respirators and Dialysis. Exactly what are these aforementioned practices, techniques and options?
Cardiopulmonary Resuscitation refers to life saving methods such as attempting to restore breathing or a stopped heartbeat. In hospitals and ambulances this is commonly referred to as Code Blue or Code 3. Why would you want this option? If you suddenly had a heart attack any rescue personnel would immediately begin these measures, however, if you were terminally ill with cancer, in your final stages of suffering, you might choose to let yourself go peaceably with no more pain or interference. This is a highly personal choice, and one that must be considered carefully.
Intravenous Therapy refers to the placement of fluids in a bag, attached to a tubing device with a needle which can be used to introduce glucose, medicine, etc., into your bloodstream in an effort to prevent death, or prolong life. This is a fairly common procedure used in both routine and serious medical circumstances.
Why would you want this option? There are people who are either very ill or elderly who just want to die quietly. If you are 85 and feel that you have lived a full, happy life, and are ready to go when it is ‘your time’, you might not want someone to sustain your life and / or suffering. This choice must be weighed carefully before a decision is reached, as refusal of treatment may have serious outcomes.
A feeding tube is a device used to feed people who are unable to feed themselves. This allows the body to maintain itself, without effort from the patient. This can be used in people who refuse to eat, or in those whose bodies, due to chronic illness, will no longer allow them to eat. This is a very topical issue because of recent Supreme Court decisions regarding comatose patients and feeding tubes. If a person is brain dead and has been in a coma for 30 years, should you continue to ‘feed’ their body? This is an important reason to let your opinions and decisions be known before something tragic happens. You might want them to let you go, or you may be trying to say, ’please don’t pull the plug!’.
A respirator is a device used to sustain breathing for a person who cannot breathe on their own, commonly referred to as life support. This is self explanatory, your decision should be known and legally prepared.
Dialysis refers to a common procedure used to assist those with renal failure (kidney failure). This device pulls the blood from your system and filters it before returning it into your body. It is a mechanical ‘kidney’ that is both tiring and very painful. It does, however, save your life. A person can not live without their kidney functions. Many people may be in poor health with various other ailments when their kidneys fail. The extent of their other problems decides for them whether the pain and weakness, not to mention the expense and the time involved, are worth it to make them live a little bit longer. They are concerned with the quality of their lives, as well as the longevity.
Although it would be hard to make a decision about something that is, as of yet, not effecting you, it is important to make your wishes known. Your ‘living will’ can be amended and / or changed in the future. Your unspoken thoughts and decisions can never be heard.
Okay, so now you understand what a ‘living will’ is, so, what is a durable power of attorney?
This refers to a written document in which you select someone else to be your representative in the event of your inability to make decisions for yourself, regarding your health care. This means you are, in effect, giving another person the right to create a ‘living will’ on your behalf.
When choosing a ‘proxy’ you should think about your decision very carefully. Who do you want making these types of decisions for you? Who do you trust with your life?There are provisions in most state laws which will allow you to have a document created by a legal expert (attorney) for matters pertaining to living wills. The durable power of attorney is a very serious document, requiring exact terminology and specific instructions. Imagine that you were struck suddenly incapable of making a decision, but, on a temporary basis. Maybe an accident induced coma, that you will recover from in a matter of days. Yet, while you are rendered incapable of a decision, that decision will be given to the person named in your living will (durable power of attorney). Do you think this person will make a reasonably informed, intelligent and knowledge decision on your behalf?
Some other things to consider, regarding a durable power of attorney, are organ donation, pain relief and medications, brain death, last rites, as well as cardiopulmonary resuscitation (CPR), Intravenous Therapy (IV), Feeding Tubes, Respirators and Dialysis. After reading the information above on these you are, by now, aware of the serious implications and the type of power associated with this legally binding document.
If you explain what you want, and have legal documents to back this up, your ‘proxy’ will make all decisions when you can not. Make sure you are comfortable with the decisions you decide upon, because you may not have time to think about those things later.
If you do not believe in organ donation, make your feelings known. Never assume your ‘proxy’ will automatically know your feelings, thoughts and beliefs. The entire concept of ‘power’ in this document does not refer to the power given to another person over your life, it refers to the power you have while alive to make these decisions (in writing) for yourself.
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