Thought about End-of-Life Decisions Before?


In an American society, autonomous decisions about end-of-life care are an individual’s right. Ironically, many individuals fail to have written proposals on how their end-of-life treatment should be. In times where patients become incompetent, their failure to write down specific instructions on end-of-life decisions may cause unyielding stress and discomfort to their family members and medical staff. 

In the article, “Taking Responsibility for Death”, Susan Jacoby discusses how most Americans prefer the option of being allowed to die over being saved by a physician. More than half of the opinion polls also show that Americans prefer end of treatment if the chances of recovery are slim to nothing and if they were in immense pain. What is interesting is that only a small few of those same people discussed these desires about end-of-life decisions with their spouses, loved ones, and children. This indicates that although there is a desire to maintain free will during end-of-life, there is a gap in initiatives to record those desires. This could be due to the American death denying culture or its habits of procrastination (I am not dying yet, so I don’t need to think about it!)

Regardless of the reasons, Americans have the responsibility to make their own decisions on end-of-life preferences, because it would be easier for the health care staff, for their loved ones, and for themselves. When the individual is unable to make competent decisions or communicate what their true desires are before that lack of competency, it hurts everyone. So, in order to prevent that, Americans should make it a priority to write out a living will. Before writing a living will, the individual should articulate and discuss with their loved ones and physicians what their end-of-life preferences are. Once those issues are discussed, there is no confusion when their end of life does come. During the end-of-life timespan, the patient’s families should respect the patient’s wishes and make it their priority to give them what they want. Sometimes patients or family members don’t know enough to question doctors, but they should be given the right information to make any further decisions concerning their end-of-life treatment. Everybody has a right to question and seek answers from their healthcare provider. At the same time, healthcare providers have the right to accept or refuse certain treatments or medical procedures if they highly feel that it is wrong.

All in all, there should be an awareness within the American society to promote the detailing of end-of-life preferences by individuals to their loved ones and medical staff so that there is a clear agenda of what is to come. This would help lower stress, reduce confusion, decrease wasted time, and eliminate any unnecessary medical expenses. In addition, taking the initiative to understand one’s end-of-life preferences would grant great security to oneself and to one’s family.


8 thoughts on “Thought about End-of-Life Decisions Before?

  1. I agree with you that everyone having advanced directives and what not would make everyone else involved way less stressed at the time of death. But, I liked what you said about the culture we have in America about always procrastinating everything. Which is so, so true, as Americans we are always putting off everything until the last minute, sad, but true. Anyway, I think that regardless of how touchy the subject might be we all need to just get over it and face the fact that we need these Advanced Directives in place. So that we cause less stress and pain on our doctors, and loved ones at the end of life. Most definitely, everyone has the right and privilege to call the shots at their end of life, so why not? We are all going die in the end anyways, why not make it easier for everyone, including yourself?

  2. I too find it very ironic that important individual rights and decisions aren’t even made until incompetent and stressful situations arise! Next, I couldn’t agree more in your reasoning behind the awful procrastination and gap in recording of desires; people are simply death denying and aren’t worried about it until it’s on their doorstep! When the time comes where decisions about treatment options arise, I agree that everybody has a right to question and seek answers from their healthcare provider. A great solution to prevent stressful family situations would definitely be promoting awareness; having knowledge to prepare for such events would solve them from the start!

  3. You brought up many great points.Though family members may not be as intelligent or competent as doctors in the medical field, they know the patient on a more personal level, are better able to assess the situation, and question healthcare providers. I think the single most important thing that we can do now is to promote the idea of making end-of-life decisions ahead of time, like you said. Plus, preferences can be changed. So why is it that people are so hesitant yet so opinionated about such preferences? Procrastination and lack of initiative may be culprits and like many, I am also one of those procrastinators when it comes to things that I don’t want to think about. One thing I just thought about is how this all plays into our society and economy. If all of those people who said they would rather die than go through suffering actually had documentation of their preferences, where would we be heading and how would that change the medical world?

  4. It is a disappointing fact that many people do not have the necessary paperwork for their end-of-life. I agree with you that Americans have the responsibility to make their own decisions on their end-of-life. The worst thing is to be unprepared. Many people are prepared for natural disasters but they fail to prepare for the most important stage of their life. Currently, I am going through a dilemma right now and while it may not be an end-of-life situation, we as a family weren’t prepared for the news yesterday and now we are scrambling not knowing what to do with ourselves. This discussion couldn’t have come at a more convenient time.

  5. I wish I would’ve thought to mention the opinion poll that showed that many Americans want to have the ability to choose the procedures and life saving treatments they would like to undergo. It’s interesting to consider that so many people want to make autonomous decisions, have the ability to do so, yet still forfeit their rights by not doing anything about it. I also agree with you when you mentions that there needs to be more awareness on this issue. I think that if more people were to think about the possibly of losing their autonomy they would be willing to document their wants and desires.

  6. I completely agree that people should be required to make it known to their family by documentation what they want done in the case of needing to make end of life decisions. As you said it would reduce many stressful aspects. I think that as soon as you are of age (18+) then you need to have advance directives or some form of letting people know what you would want to have done to yourself.

  7. I agree that this post really underlines the reasons and rights for patient to detail out their end of life wishes before they unable to make such difficult choices due to incompetence. However, everyone knows that death is inevitable, and I believe there is a moderate level of awareness within the American society about advance directives, but still most individuals reach the end of their lives without listing out their wishes, and more importantly without talking about it with their families who have to suffer the burden of making the life and death choices of their loved one. In fact, a lot of times, families can be also partially incompetent at this period, because their emotions are all over the place because of they are in a process of letting go of someone they love. That is why I believe the healthcare provider should make majority of the decisions when someone is at their end of life and incompetent as long as the decisions made are in the best interest of the patient.

  8. I agree with your point about people not taking the initiatives to communicate their wishes to their family concerning end of life decisions, and I think it is the result of not only the death-denying-culture that we live in, but also procrastination. For instance, I personally don’t have any problem talking about death, yet I don’t have an advance directive because I am procrastinating. I know I wouldn’t want to be kept alive in PVS, yet I haven’t made that desire known because I doubt that I will find myself in such a situation anytime soon. I think most people have this mindset. Nevertheless, I still wonder how many (young) people truly know about advance directives. Most people people know about will, but I doubt a lot of people know that they may set up a document that indicates what they would want if they find themselves unable to do so.

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