SAFEGUARD
FOR LIFE-ENDING DECISIONS
STATEMENTS
OF SUPPORT
FOR THE ADVANCE
DIRECTIVE OF THE PATIENT
Once the patient has created at least a good draft
of an advance directive for medical care,
it should be shared with others who will be affected by the decisions
it embodies.
Then at least those family members and friends who have been selected
to be proxies
should be asked to create their own statements of support,
expressing their willingness to carry forward the settled values of the
patient
if and when the patient is no longer able to make medical decisions
or to express his or her wishes.
And in the context of life-ending decisions,
such statements of support should explicitly address
the question of whether the family members and/or the proxies
do in fact support the philosophy of life-and-death explained in the
advance directive.
When several family members or proxies have the same
views,
they can all sign the same statement of understanding and support.
But it would be even better if each person were to write an individual
statement.
In some cases, one circle of friends and relatives
will be serving on the Medical Care Decisions Committees of one another.
This will encourage all to be serious about their advance directives
and to consider carefully how they will participate in the deaths of
others in the circle.
HOW STATEMENTS SUPPORTING AN ADVANCE DIRECTIVE
WILL DISCOURAGE IRRATIONAL SUICIDE
AND OTHER FORMS OF PREMATURE DEATH
When several people read and comment on the advance
directive of the patient,
these significant other people will be closely attuned to the mood of
the patient.
And if this patient has any suicidal tendencies,
any irrational urges to kill himself or herself will likely be noticed
by the family members who are discussing
which conditions would lead to the decision to continue living
and which conditions would lead the patient to choose death.
And if there is any danger of irrational suicide,
these close family members and friends can do their best
to discourage the patient from killing himself or herself.
An irrational suicide is harmful
to the patient,
even if the patient wanted death at that moment.
And an irrational suicide will seem tragic and regrettable
to all family and friends who go on living.
This circle of people will be discussing the ideal
pathway toward death
as selected by the patient.
When they agree on the appropriate time and place for death to come,
they will also be acknowledging other times and places
where the death would be inappropriate
and premature.
Sometimes the close family members will be best able to uncover
death-planning that would lead to death
before it would really be best for the patient.
When others participate in the death-planning process,
a wiser decision is likely to emerge: not too soon and not too
late.
created January 25,
2007; revised 1-26-2008; 2-14-2008