Category Archives: Living Wills

Their Decision, Not Yours – The Duty of a Health Care Proxy

The New York Times has a recent article called “An Ill Father, A Life and Death Decision.” It’s about a daughter who has been appointed as the health care proxy for her father.  This means that when he is unable to make or communicate his health care decisions, she communicates his wishes to his health care providers. Notice that her role is not to make the decisions for him.  In the story, her father is sick again – his liver, lungs and kidneys are failing. The doctors ask her if they should intubate him.

I am acutely tempted to answer, “Of course not — my father would not want heroic measures.” But I hesitate because I know it might not be true. In the past, he has wanted everything possible done. This night is different, but I do not know if his answer would be different.

I look at my father. It is hard to tell if he is conscious. No one else is looking at my father. Everyone is watching me closely.

Finally, I say out loud the only thing I know to be true. “In the past, my father has asked that everything possible be done.”

Then I bend over my father and ask him in a clear, strong voice: “Daddy, do you want to be intubated again? Squeeze my hand if you want to be intubated.” I wait, but he does not squeeze. Instead, he surprises us all by nodding his head. He is weak, but the nod is unmistakable.

In the story, the nurses seem annoyed that they chose this invasive procedure.

What the doctor and nurses do not know, what I hesitate to admit even to myself, is that I almost gave them the answer they wanted: the reasonable one. But I would have been terribly wrong.

My father never really recovered. He could never again breathe without a respirator, he never left the hospital bed, and he eventually needed dialysis and a feeding tube. Six months later he died of heart failure.

I suppose my father’s decision was a mistake. But it was his mistake to make, not mine. My role was to support my father, no matter what, and to tell the truth, no matter how hard.

This is why when I talk to my clients about their health care proxy, I stress that it is not just enough to appoint someone to make those health care decisions, you must talk to them about the decisions you want them to make. You have to actually have the conversations about end of life care, intubation, feeding tubes and all those things that make most people uncomfortable. You also have to make sure that you are appointing someone who is capable of communicating your wishes during a medical crisis.

A lot of my clients use the Five Wishes Living Will to help them with these decisions. Other choose a living will designed by their church, still others write their own.  The important thing is that you do it, and then talk about it with those people to whom you are giving the authority to communicate those decisions.  And then trust that they will convey your wishes, not theirs.

How to Communicate Your Health Care Wishes

As part of the work I do with my clients, one of the things we always talk about at our first meeting is whether they have signed a health care proxy.  A health care proxy is a legal document which appoints another person to make health care decisions for you in the event you areContinue Reading

Terry Schiavo, Part 2?

The Palm Beach Post in Florida is reporting a case that is similar to the Terry Schiavo case of a few years ago.  Both cases involve a young woman who has become incapacitated and did not leave behind written instructions regarding her wishes for medical care in that circumstance.  These instructions are often referred toContinue Reading

How Clear Are Your Last Wishes?

This is the title to a recent New York Times health blog post. (You need to register to read it, but it is free.) The author recounts her experience with her family trying to deal with her grandfather’s illness and their attempts to interpret his wishes about the end of his life.  She writes: …theContinue Reading

Living Wills – You Need to be Specific

I’ve heard it said that the Health Care Proxy is the keys to the car, and the Living Will is the map.  If you want your health care agent to be able to make good decisions for you when you are unable to decide for yourself, then you need to give them a detailed mapContinue Reading

Changing Your Living Will During Pregnancy

Most people think that the time to revise their estate plan, including their health care proxy and living will is when a big change occurs: marriage, birth of a child, divorce, etc. However, as Shelly Mactyre, of The Fig Tree  points out, you may wish to change your living will or health care directive whenContinue Reading

Living Wills – One Year After Terri Schiavo

The National Academy of Elder Law Attorneys has posted an article stressing the importance of having a living will (sometimes called a life support statement) drawn up. While the spotlight this time last year on the Terri Schiavo case brought forth a great deal of discussion generated about life and death issues, the National AcademyContinue Reading