What Decisions Will Your Healthcare Agents Make?

What Decisions Will Your Healthcare Agents Make?

Will your healthcare agents be equipped to make the choices you would make?

Tom’s doctor told Libby, “This will buy us some time.” As Tom’s primary healthcare agent, it was her decision. She nodded silently, fearfully.  The doctor began intubating her husband.

healthcare agents and intubation

Six weeks later, a different doctor rather unsympathetically stated, “Tom will never wake up. We’ve tried everything. It’s time now to turn off the life support.”

Oh, how she wished she could have a do-over and re-wind those six weeks. Libby could never have imagined the prolonged suffering Tom had endured for six torturous weeks as doctors tried in vain to keep him alive.

If only she’d had the courage to say “No” to the first decision to intubate Tom. Libby remember a news story she and Tom had watched about an accident victim with tubes protruding from his body every which way. He’d made a casual remark, “I hope that never happens to me.” When the doctor suggested intubation, she’d felt resistant in her gut, but she had conceded. Now she felt flooded with regret and guilt.

While medicine is based on science, the art of delivering care to patients is indeed art, not science. No one can accurately predict the outcome of medical procedures, medications or surgeries. Each case, each decision is unique.

Human nature infuses hope, particularly in dire circumstances.

Family members cling to hope, believing their loved one will beat the odds. Physicians offer hope—always believing there’s another procedure to try, another medication to administer—because for a doctor, acknowledging imminent death feels like admitting defeat.

End-of-life healthcare decisions are impossibly difficult.

Urgent, end-of-life medical decisions are fraught with uncertainty laced with hope. Thus, the challenge for healthcare agents making decisions on the patient’s behalf. The first decision is pivotal, often leading to a slippery slope of efforts that merely extend the dying process.

Checked boxes won’t sufficiently communicate your wishes.

Providing clear guidelines by writing a truly meaningful healthcare directive requires more than checking a few boxes on a boilerplate form. One of my recent healthcare directive coaching clients wrote the following specific guidelines in her healthcare instructions (living will) regarding CPR:

Regarding CPR
I want to receive CPR if my heart or breathing stops unless:

1. If I am older than 80, I do NOT want CPR.

2. If I have been diagnosed with a serious, potentially life-threatening illness, I do NOT want CPR.

3. If I have been in declining health that is not expected to reverse, I do NOT want CPR.

4. If am 80 or younger and have been in good health, I do NOT want CPR if my medical team determines that I have little chance of survival, or CPR will not help me, or the process of resuscitation will likely cause significant suffering.

In other words, I would want both the risks and benefits of CPR to be considered before CPR is administered. I realize there may not be time for a lengthy discussion or decision-making process. If in doubt, do NOT perform CPR.

Will your instructions support your healthcare agents?

Do your healthcare instructions provide enough support for your healthcare agents to make wise decisions on your behalf? Why not read through your document once more—today in fact—to consider how your healthcare agents would be guided by your words if CPR or intubation were required in an emergency. Have you, like my client, set any boundaries?

Maybe it’s time to revisit and revise your directive. Need help? Healthcare Directives from the Heart will guide you through a structured coaching process and equip you with user-friendly tools to successfully—and thoughtfully—express your future healthcare wishes.

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