End-of-Life Decision Making
"Do everything you can to save my father." Doctors hear this often. It's the way many families respond as they obviously do not want to lose a loved one, but it's not necessarily what their father would have said. That's why people need to think about advance directives (sometimes called living wills) for medical care and the appointment of a health care agent.
What are advance directives?
Advance directives are documents, written while a person is still able to make decisions, that express their wishes related to life support in case they are not able to express their wishes in the future. These include cardiopulmonary resuscitation (CPR), respirators, and any other measures that the person cares to list.
Why does the advance directive only apply if the person is mentally unable to make decisions?
When the person is still mentally capable, the doctor can just ask the person about his or her preferences concerning treatment. The advance directive is a document that gives the health care team guidance on the patient's wishes only if the patient is unable to express those desires.
Why would someone not want CPR?
Most relatively healthy people would want CPR if their heart were to stop. That's because if CPR is successful, they can expect to recover, leave the hospital, and continue with their active lives for a reasonable period of time. Some elderly or terminally ill people who have become incurably frail might decide not to have measures instituted that will either only extend their lives in a vegetative state or result in their being senseless because of their specific medical condition. Some people decide that they won't want CPR and respirators once they can no longer remember the names of their children (or their own names).
Why would someone want CPR?
Some people might make the opposite decision. They might decide to have CPR and machines to support artificial breathing because they want to live as long as possible. If you make a decision like that, it will be respected by doctors and hospitals. The doctor is expected to make a reasonable decision about which measures might help and are reasonable. The input of the patient in this process is very important. Your personal and religious beliefs will influence these decisions.
Medically Reviewed by a Doctor on 1/27/2015
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