5: Where do you draw the line between a quality of life
preserving and the remnants of biological life
should be mercifully shut down?
It is extremely difficult to decide just when to 'pull the plug'
other persons, especially people we have loved and cared about.
very significant help in making this determination
be a written statement from the person whose life it was,
out some tests or criteria for making life-ending decisions.
this is the place in your Advance Directive
you should explain as clearly as you can
your proxies should proceed in these difficult situations.
You should be careful about being merely negative
you write your Advance Directive.
people merely make a long list
the medical treatments and interventions they do not want.
they fail to explain clearly when they do want these procedures.
often their objections to the treatments
to be esthetic rather than medical or philosophical.
example, some people say they do not want any tubes.
they remember seeing others attached to complex machines
they were dying in the hospital intensive care unit.
do not fully understand what these tubes and machines do;
they know that they did not like the sight.
image they retain was one of undignified dependence.
they hope to avoid such scenes
refusing to have any tubes
used in their own care.
But if we think more deeply, we might welcome tubes
a temporary means to return us to meaningful life.
of us would gladly accept a week in the hospital
from a surgery that saves us from death
enables us to return to a rich and meaningful life.
almost all surgeries include having tubes
in various parts of our bodies serving various purposes.
So you probably should not focus on the medical means
might be used but focus on the goals and the outcomes.
you are a doctor yourself,
is probably not meaningful to second-guess
means employed by your
doctors in your treatment.
it is wise for you to establish your own goals for medical care.
YOUR LAST YEAR: CREATING YOUR ADVANCE DIRECTIVE FOR MEDICAL CARE
A conservative Answer to this Question
say that the primary goal
of all medical treatments
be the sheer preservation of
might want all treatments that have any hope
keeping the biological functions of your body going,
if the length of that 'survival' is short.
A middle-of-the-road Answer would focus on meaningful survival
the fundamental purpose of your medical care.
might want all medical treatments that can restore you
a level of functioning that you find meaningful.
limitations would be too burdensome for you?
you later change your mind about living a diminished existence
the only alternative is certain death?
A more radical position might say that medical treatments
restore full personhood,
as defined in your previous Answer.
quality of life you
want to result from medical treatment
consciousness, memory, language, & autonomy.
hardest of these to achieve will be autonomy
able to set your own goals in life and to carry them forward.
limitations on your autonomy would you accept
still find that you have a sufficient quality of life to continue
might in this answer cite some other persons you have known
former persons) whose 'lives' were preserved
tho they had a very low level of autonomy.
life as a former person would not
be acceptable to you,
should say so in your Advance Directive,
that level of function might be so low
you would not be able at the time
make meaningful decisions or to express your wishes.
The selection above is the beginning of Question 5 from the book:
Year: Creating Your Own Advance Directive for Medical Care.
If you click
this title, you will see
the complete table of contents.
would like to see one person's Answer to this Question,
go to James
Park's Advance Directive for Medical Care.
Scroll down to Answer 5.