Living wills, health care proxies, or expanded healthcare declarations — documents known as advance care directives — give you a voice in decisions about your medical care at the end of life. Without these documents, choices may be left up to a doctor or a judge — someone who does not know your values, beliefs, or preferences. It may well cost a small fortune in requiring a guardianship proceeding to get an answer. In Florida even the State (say, the Governor) may get involved.
These powerful documents make sure that you get the treatment you would want for yourself if you couldn’t communicate your wishes, and allow you to appoint your trusted agent (family member or friend) to make decisions for you. Here are a few myths that shouldn’t get in the way of creating a health care power of attorney or living will:
Concern: More care is always better.
Truth: Not necessarily. Sometimes more care prolongs the dying process without respect for quality of life or comfort. It’s important to know what interventions are truly important. It’s often impossible to know that in advance. That’s where the advice of a healthcare team and an authorized agent are invaluable.
Concern: Refusing life support invalidates your life insurance, because you are committing suicide.
Truth: Refusing life support does not mean that you are committing suicide. Instead, the underlying medical problem is considered to be the cause of death.
Concern: If medical treatment is started, it cannot be stopped.
Truth: Not starting a medical treatment and stopping a treatment are the same in the eyes of the law. So you or your health care agent can approve a treatment for a trial period that you think may be helpful without fear that you can’t change your mind later. However, be aware that stopping treatment can be more emotionally difficult than not starting it in the first place. If you are in a coma or so incapacitated you can’t make a rational decision, you need someone else you appoint to make that decision.
Concern: If you refuse life-extending treatments, you’re refusing all treatments.
Truth: No matter what treatments you refuse, you should still expect to receive any other care you need or want — especially the pain and symptom management sometimes called intensive comfort care.
Concern: Stopping or refusing artificial nutrition (think food) and hydration (think water) causes pain for someone who is dying.
Truth: Unlike keeping food or water from a healthy person, for someone who is dying, declining artificial nutrition or intravenous hydration does not cause pain. A medical professional, with your representative, makes the decision so you receive the comfort you need.
For more on setting goals for end-of-life care and avoiding common pitfalls call our office for an appointment — 305/670-6750.