All very well in theory, but not in practice
Posted on Monday 24th September 2007
The ethos is that an individual with chronic and/or deteriorating health problems states some intentions as to what they do and do not want done to them in the event of a significant decline in their condition. For example: a patient with incurable cancer may decide that if they have a cardiac arrest that they do not want to be resuscitated.
Now this is fine in theory as it is intended to prevent patients being subjected to undignified, invasive and aggressive treatment if they are unable to state their wishes. It also spares their relatives the burden of being faced with the guilt of being asked to sanction pulling the plug on their loved one. It also protects the doctors from having to approach the patient in the throes of their illness to ask if they are ready to die.
Unfortunately these simply don’t work in reality. It is a very brave person who, while staring death in the face, declines active treatment. Regardless of their previously stated intent, my experience is that if faced with a choice of “Do nothing and you die, or do something and you may live”, few take the former. I’m not disparaging their change of heart as it is a natural decision.
This system is simply unworkable, and it is probably for that reason that it doesn’t exist in the UK. Of course there are scenarios in which such an advance directive is useful but they serve to confuse more often than they help in my mind. Please contribute with your opinions as I don’t claim mine is absolutely correct - just the result of jaundiced experience!
The Advance Directive is like going to the loo and pissing on the floor.
Furthermore, I find it strange that the Howard government blocked euthanasia laws being enacted in the Northern Territory some years agao , and yet have the Advance Directive.
We all crave a choice of death that is many things - from saying certain things to your loved ones, to passing away without pain. The most important to have with death, is your dignity.
Is it too much to ask for a person who is terminally ill to emphatically decide to go on their terms? I cite the Dutch law in this. It is practical and would serve as a much better model than the “Cover everyone’s arse before I die” Advance Directive.
The terminally ill deserve something better.
Totally. as anthony says, the thing is wishing to die with dignity, and that is something many people are denied.
It’s time that governments over the world woke up to this. As a teacher, I find many young people actually support euthanasia, so maybe it will come through in a generation.
twenty years ago, my Godfather died, very painfully, of cancer in his thirties. his wife commented that ‘If he’d been a dog, he wouldn’t have been allowed to suffer like that.’ In a sense, this highlights the hypocrisy.
Though where this will leave the hypocratic oath, i don’t know…
Ed
My mother was a card carrying supporter of euthanasia, so when she went into low level care in 1998, a medical power of attorney document was signed by her, my sister and myself. This was witnessed by the CEO of St Anna’s Residential Care and her doctor - everyone involved in her care and treatment were well aware of her final wishes.
Last year, after a hip replacement operation, complications set in and she died ………pain free with diginity …..her wishes were met.
Having watched both my parents die…….Dad …distressed and in pain…..or Mum, peaceful, pain free with music playing….I know which one I want.
Having read through what I’ve written above I realise it may inadvertently imply that I don’t think people should be allowed to die with dignity. This could not be further from the truth and I am a strong advocate of doing what is appropriate. In many cases this would be euthanasia. While not right for everyone, and against the religious wishes of many, euthanasia could have a justifiable role in modern medicine if properly regulated and actioned.
What I meant to say is that the current advance directive system in Australia is unhelpful and poorly thought out. While it could be useful, the documentation is often vague and so clinicians become unsure of the patient’s exact wishes. This sometimes results in resuscitation despite an order for fear of litigation for not “treating” the patient.
I think Anthony has hit the nail on the head and there needs to be a federally enacted piece of legislation set out in black and white terms. Everyone should be allowed to declare their wishes to be acted on if they are unable to express those wishes. In other words the advance order should be capable of carrying as much weight as if they had said it themselves. Just remember that people must be allowed to rescind an order and change their minds at any time. I have seen this happen, as mentioned above.
also, i think the advance directive is actually on it’s way here too rick. it’s already here for jehovah’s witnesses and i think the recent changes in consent law in UK this year have resulted in advanced directives and advocates being recognised.