Question
12: When should all curative treatments be ended?
Thru most of the history of medicine, doctors
have always done their best to forestall death. Death
came anyway, because there was little doctors could do. But
in the 20th century, this situation changed rather dramatically, at
least in the advanced countries of the world. Medical
science and technology became so able to
provide mechanical and chemical supports for
the natural functions of the human body that
death was postponed for months and sometimes for years.
If you had lived in any previous era, you
would have been concerned mainly about dying too soon. But
now your problem might sometimes be dying too late. For
the first time in history, you can decide the best time to die: not too soon—when you still
have good reasons for living, and
not too late—after
meaningful life has come to an end. Because
medical science and technology can keep you alive, you
should decide how long you
want to be sustained —and
when you would prefer to die a natural death.
Life-ending decisions have been openly acknowledged in
the practice of medicine only recently. But
almost every death that occurs in a hospital (which
is 80% of all deaths that occur in the United States) includes
some important medical choices made by: the
doctors, the patient, and/or the proxies for the patient. But
these momentous decisions seldom appear in the medical chart, except
as changes in medication or the termination of life-supports.
Medical practice requires detailed records of all procedures, for
instance, the dates, times, & amounts of all medications given. But
when it comes to life-ending decisions, few records are kept. It
would be better for all concerned to document important decisions: The
doctors should put their prognoses into writing, even
if they are uncertain about the course of the disease. Second
opinions of other doctors should also be committed to writing. The
patient's decisions about medical treatment should be written down. Proxy
decisions about life and death should also be recorded.
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YOUR LAST YEAR: CREATING YOUR ADVANCE DIRECTIVE FOR MEDICAL CARE