What is an advanced medical directive?


© Betty O. Spangle

Ever been asked if you had an advanced medical directive? Well, maybe this will help you understand exactly what that is! There are two types of Advanced Medical Directive. These are called (1) living wills and / or (2) a durable power of attorney. Although both are advanced directives they are very different legal documents.

A living will is a set of written instructions that explain your wishes on the matter of health care in an emergency or terminal condition. These are referred to as ‘living wills’ because they are actually in effect while the patient is still alive. You are able to make decisions, in advance, about such serious matters as cardiopulmonary resuscitation (CPR), Intravenous Therapy (IV), Feeding Tubes, Respirators and Dialysis. Exactly what are these aforementioned practices, techniques and options?

Cardiopulmonary Resuscitation refers to live saving methods such as attempting to restore breathing or a stopped heart beat. In hospitals and ambulances this is commonly referred to as Code Blue or Code 3. Why would you want this option? If you suddenly had a heart attack any rescue personnel would immediately begin these measures, however, if you were terminally ill with cancer, in your final stages of suffering, you might choose to let yourself go peaceably with no more pain or interference. This is a highly personal choice, and one that must be considered carefully.

Intravenous Therapy refers to the placement of fluids in a bag, attached to a tubing device with a needle which can be used to introduce glucose, medicine, etc., into your bloodstream in an effort to prevent death, or prolong life. This is a fairly common procedure used in both routine and serious medical circumstances. Why would you want this option? There are people who are either very ill or elderly who just want to die quietly. If you are 85 and feel that you have lived a full, happy life, and are ready to go when it is ‘your time’, you might not want someone to sustain your life and / or suffering. This choice must be weighed carefully before a decision is reached, as refusal of treatment may have serious outcomes.

A feeding tube is a device used to feed people who are unable to feed themselves. This allows the body to maintain itself, without effort from the patient. This can be used in person’s who refuse to eat, or in those whose bodies, due to chronic illness, will no longer allow them to eat. This is a very topical issue because of recent Supreme Court decisions regarding comatose patients and feeding tubes. If a person is brain dead and has been in a coma for 30 years, should you continue to ‘feed’ their body? This is an important reason to let your opinions and decisions be known before something tragic happens. You might want them to let you go, or you may be trying to say, ’please don’t pull the plug!’.

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