No one asked, because there was no hope. I’m glad no one asked, because I had nothing in writing.
No one asked to see my husband’s living will when he suffered a heart attack in 1998. When I arrived at Providence Everett Medical Center with a police officer, my 45-year-old husband was hooked up to some machines.
| The Washington State Medical Association offers forms to download along with information on advance health care directives, durable power of attorney and physician orders for life-sustaining treatment at: www.wsma.org/ patients/who_decide.html.
For forms and information on the “Five Wishes” living will, see www.agingwith dignity.org. |
I was given a choice – turn everything off immediately or wait a few days. It didn’t take me 10 seconds to decide. He was gone. And I knew what he would have wanted.
My husband had no health care directive. Who wants to take the time or face up to the possibilities?
We all should. That is the lasting lesson of Terri Schiavo. As her family’s agony plays out in courtrooms and Congress, remember this: Had she made known, in writing, her wishes for life-supporting medical treatment, her case would be a private matter.
A U.S. District judge in Tampa, Fla., Tuesday refused to order the reinsertion of the brain-damaged woman’s feeding tube. Her husband, Michael Schiavo, has said his wife told him years ago that she wouldn’t want to be kept alive under such circumstances. Her parents have challenged him in the courts.
“That’s the message to me, fill out these things,” said Dr. William Robertson, a Seattle pediatrician and former president of the Washington State Medical Association who has been an advocate of living wills since the concept was new in the 1970s. He urges doctors and patients to make sure their medical wishes are known.
“People pay more attention to it today than 10 years ago,” said Robertson, who also emphasizes the need for families to talk about end-of-life issues.
“It’s very important,” said Tim Serban, director of mission integration and spiritual care at Providence Everett Medical Center. “If we don’t write our wishes down, how is anyone going to know what we want? Who’s going to make that decision?”
Serban said it’s federal law that hospital patients be given information on advance directives.
“Model forms are readily accessible and pretty straightforward,” said Taya Briley, a registered nurse and attorney with the Washington State Hospital Association. Doctors’ offices have them, and they are available online at the Washington State Medical Association Web site.
It isn’t necessary to have a lawyer or a notary to complete advance directives. Two witnesses are needed, but “you can have two neighbors,” Serban said. Keep the original and give copies to the people you name as decision makers and your doctor.
At Providence Everett Medical Center, a new “Five Wishes” form is in use. It’s available at the hospital.
“This document is legal in all 50 states, and is both an advance directive and durable power of attorney for health care,” he said.
Serban outlined the five points: the person I want to make care decisions; the kinds of medical treatments I want or don’t; how comfortable I want to be; how I want people to treat me; and what I want loved ones to know.
You may ask “that my family respect my wishes even if they don’t agree,” Serban said.
Briley said it’s not unusual for people to be without any documents. In Washington state, she said, there’s a statutory hierarchy setting out who can make decisions. If a patient is unable to say, an appointed guardian comes first, followed by a durable power of attorney for health care, a spouse and so on.
Advance directives can address in detail the very issues Terri Schiavo’s loved ones are facing.
“Many talk about being close to death in a coma,” Serban said. “Do I want life support as the doctor recommends? Or not at all? And artificial nutrition and hydration, do I want it to be withheld?”
The Everett hospital has an ethics committee to help when patients or staff face an ethical dilemma, a situation “where there are two right answers,” Serban said
In loving families, he said, “withdrawing support may feel like giving up on them. You’ve got to say, ‘What would my mom say if she were here?’ The big key is being able to speak on their behalf,” Serban said.
People often have misconceptions that at a Catholic hospital, any and all measures must be taken to prolong life.
“That is not so much the case. We must be sure we are respecting life from beginning to end,” Serban said.
“When there is not a purpose for prolonging dying, there is no obligation to continue” with life support, Serban said. “In reality, oftentimes withdrawing life support is reasonable, ordinary and expected.”
The debate over Terri Schiavo will rage on not because withdrawing nutritional support is unusual, but because her wishes can’t be known. They weren’t written down.
“The most important thing about those documents is that people complete them,” Briley said.
Columnist Julie Muhlstein: 425-339-3460 or muhlsteinjulie@heraldnet.com.
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