COLUMN: End-of-life wishes should be made known to families
Amidst the plethora of coverage on the case of Terri Schiavo, we cannot help but think what a detriment all of this has been for both personal rights and the concept and purpose of hospice. Had Terri discussed and written her end-of-life wishes prior to her demise, perhaps they never would have placed a feeding tube and she would have died peacefully 15 years ago.
All of this brings up a number of issues that most younger people do not think about. One issue is to choose a person who you would want to make a decision for you should you for some reason become incompetent and unable to decide for yourself (Durable Power of Attorney). Discuss your wishes and choices and write them down. Perhaps in the future, a checklist that designates a person’s end-of-life wishes could be included at the time a driver’s license is obtained or renewed, much in the same way that drivers now designate a willingness to be a potential organ donor. For example, would you want to exist with minimal brain activity on a ventilator or with a feeding tube? In both of these situations, existence can go on indefinitely. It is considerably easier to honor this wish if it occurs at the start of the end-of-life decision-making process rather than initiate the treatment and then later decide to withdraw it as has happened with Schiavo.
One of the most significant factors in making choices at end of life for the writers of this article is quality of life. If faced with the prospect of a future in a “persistent vegetative state” we would prefer no treatment. Allow us to die without food or fluids and with hospice care to keep us comfortable.
Hospice care is not prolonging life or hastening death, but providing measures to maintain comfort for any symptoms that are unpleasant at the end of life. The hospice goal is to maintain dignity and quality of what life is left for the hospice patient. Hospice helps to prepare both the patient and the family for the expected outcome.
We believe that dying is a personal decision that has no business being argued in Congress or being an item on the President’s desk. End-of-life decisions in the ideal world should be contemplated, discussed with loved ones and written down so that these kinds of contentious situations can be avoided. Unfortunately, in the United States we continue to be a death-denying culture and even hesitate discussing or defining our decisions at advanced ages despite all of the press coverage at times like this. We all owe it to the surviving members of our families to make our wishes known now so they can have peace in the unpredictable future.
Pat Sadoski, BSN, MS, is the patient care coordinator at the Alpine Home Care hospice organization in Logan. D. Andy Anderson, PhD., is a professor in the biology department at USU and its principal lecturer and bioethics instructor.