What nobody is telling you about your Advance Directive

For the patient and family:

The doctor just handed you an advance directive and told you to fill it out. What do you do now? Do you want a feeding tube? Do you want to be put on a ventilator? How do you answer these questions? Do you even know what these questions mean? The doctor is asking you the wrong questions. What he should really be asking is, “How do you want to live after a serious illness or injury? What kind of condition/suffering would you be willing to endure?”

The advance directive form in not just a death form, it goes into effect when you can no longer think clearly enough to make your own decisions. Now, maybe you will only be incapacitated for a short period of time and someone will need to make your medical decisions for a few weeks or maybe this will be forever. An advance directive is one way to stay in charge of your life even when you can’t speak for yourself.

So the right question is, “What kind of life would you want to live if you your mind no longer worked well or if it didn’t work at all?” Now for some people, any condition is okay as it is God’s will to determine how we live and when we die. But for others, you can’t think of anything worse than living in a nursing home, wearing diapers, having other people feed you and not being able to recognize your loved ones. But how will your doctors know what you want if you don’t tell them? Doctors know how to practice medicine. But what they don’t know is what would make for a “meaningful recovery” for you. So you have to tell them.

Here is my “Meaningful Recovery Statement”:
“I value a full life more than a long life. If I have lost the ability to interact with others and have no reasonable chance of regaining this ability; or if my suffering is intense and irreversible, even though I have no terminal illness, I do not want to have my life prolonged. I would not then ask to be subjected to surgery or to resuscitation procedures, to intensive care services, or to other life-prolonging measures, including the administration of antibiotics, blood products or artificial nutrition and hydration. I also believe that the financial and emotional burden on my family should be considered in making these types of decisions.”

Because I have written this in my advance directive the doctors will know what is important to me. Of course this doesn’t have to be your statement. Write one that is meaningful to you and attach it to or write it on your advance directive.

One more thing, please address the issue of terminal vs. non-terminal situations. If you are terminal, then it is important your doctors know where and how you would want to die. If you are only severely disabled but not going to die soon, then you need to let them know what kind of life would be tolerable for you. The best way to be protected is to write it down.

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