Die the way you want to: Advance care directives should be as routine as driver’s licences

Die the way you want to: Advance care directives should be as routine as driver’s licences

by Dr. Dan Morhaim

As an emergency room doctor, I’ve seen this all too often. An ambulance brings in a frail, elderly nursing home patient with shortness of breath, irregular heartbeat and plunging blood pressure. The wasted and contracted limbs indicate years of incapacitation, and the medical record reveals a long history of dementia. As we intensely work to restore stability, probing paper-thin skin for a vein, the patient suddenly goes into cardiac arrest.

Does the patient have an advance directive or a do-not-resuscitate order? No. So the ER team goes into full CPR mode, cracking brittle ribs with each chest compression. If “successful,” the patient will endure pain and confusion that may last for the rest of his or her life, however short or long that may be.

Is this care, or torture? The only ethical and legal way to avoid this scenario is when patients have made their wishes known in advance and appointed someone they trust to make decisions when they are no longer able to.

There comes a time when most of us would choose a natural death rather than use medical technology to prolong life for what is usually only a few extra hours, days or weeks. But when that moment comes, we are often not in a position to speak for ourselves.
Read more: http://www.post-gazette.com/stories/opinion/perspectives/die-the-way-you-want-to-advance-care-directives-should-be-as-routine-as-drivers-licences-638477/#ixzz2Bh6CcnSB