National Advance Medical Planning Day: Pushing People to Say “No”

Today is National Sign an Advance Directive Day, or something like that. And the stories are out trying to stimulate us to action. As I have noticed when proposals to legalize assisted suicide are reported, they are all the same. It’s cookie cutter journalism: Start with a horror story.  Then switch to how that horror story could be avoided, if only—with assisted suicide by assisted suicide, with advance directives, signing an advance directive refusing care.

Don’t get me wrong. I support signing advance directives. But the stories don’t do justice to the complexity and seriousness of the subject. And, they all push in one direction—say no—even when they mention that you can say yes.  Typical of the genre, one in today’s Silicon Valley Mercury News, which clearly pushes in a certain direction.  From “National Day to Support End-Of-Life Planning:”

“There’s no right or wrong answer,” said Zarina Kaji, 57, of Los Gatos, who is organizing an April 22 forum at the Milpitas-based India Community Center to help the people complete the forms. “It should be your own decision — and you should not have to burden someone else to decide for you,” Kaji said. “It is the greatest gift to give to your children.”

Filling out the forms addresses questions that, left unanswered, could lead to an unnecessarily prolonged, uncomfortable or even comatose end. People filling out the forms ask themselves questions such as: “Is my life worth living only if I can talk to family or friends, wake up from a coma, or feed, bathe and take care of myself? “Is my life is always worth living — no matter how sick I am and how much care I require?”

My recommendation: Do not sign a living will, because that empowers the doctor to decide. Do sign a durable power of attorney for health care—perhaps called something different in your state or country—that names a surrogate to make your decisions based on your values and the facts of the actual circumstances.  For those opposed to euthanasia and dehydration of cognitively disabled patients who live in the USA, the Patients Rights Council (for which I am paid to consult) has the Protective Medical Decisions Document.  It is state-specific and well worth your considering.  And for those out of the country, perhaps the language could be borrowed to meet your nation’s requirements. Or, even if your country doesn’t have such laws, it can at least tell doctors what you want.

And here’s another fact that these stories don’t tell you. If you say no treatment, it will be honored. If you say, yes to treatment, it might not be—as in current and potential future medical rationing and futile care theory.  People need to know about that problem so they can push back democratically to stop the agendas.

The story also mentions the POLST (Physicians Order for Life Sustaining Treatment).  I am not against them in theory, but as with most things in this field, the devil is in the details, and I am hearing some worrying things. I need more info about POLSTs before commenting further, so more on that another time.