In the article “Taking Responsibility for Death” by Susan Jacoby, we discuss the issue of family members having to make difficult decisions for their dying family members. We have learned that the United States is one of the highest death denying cultures in the world. It is because of this death denying way that causes so many problems with the decisions that must be made at the end of a family member’s life. This would not be an issue if we had a set plan for how we would like to be handled if the worst should come to us. Polls show that most Americans would prefer to be left to die if a hundred percent recovery was not possible. However, strangely most family members never discuss such a topic with one another leaving them with a very difficult decision. This also puts a lot of stress on the family dealing with a death.

This is why I believe everyone should have to have a written document of their preferred method of treatment so that both doctors and family could know how to move forward with a patient who could not make a decision for themselves. This document should be done through the health care provider and made available when needed. During the period of time at the end of a life, emotions can cause someone to make a rash or illogical decision out of grief or ignorance. However, I feel like we can plan out everything, yet it is impossible to know how or if some ones decisions will change when they are actually facing a life or death situation. That is why this is such a debated argument. This is why if a plan could be made with the healthcare provider the family should listen to the provider yet have the power to overrule the provider’s decision.


11 thoughts on “EOL

  1. I agree with what you’re saying because families never know what is going to happen and they should talk about what they want done in case of something happening to them but unfortunately more often than not that does not happen. I also agree that everyone should have a written document that states what they want done in the event of an tragic event. But there are plenty of forms that this can be done with, people just do not do them because they never imagine that something of that sort would happen to them.

  2. In general, human beings never truly know what decisions want until they are put in that specific situation. With that in mind, advance directives are important documents that help us think about what we would like to have done at the end of our lives, incase we become incompetent, but at the same time, it is highly possible for us to change our minds, when that choice we made is being acted upon. With such confusion within ourselves, I find it very hard to agree with greatly involving family members when it comes to the specifics on what we would want during our end of life. As long as the healthcare provider makes decisions in that are in the best interest of the patient based on their health, as well as based on the morals and values of the patient, which the family members should know or have already discussed with the patient as some point, then I believe there really is no need for the family to rigorously question the health care services.

  3. I completely agree with what you wrote about the fact that our being a death denying culture and how that and our fear keeps us from planning for emergency situations and writing down what we would like to happen. Too many people go through treatments and procedures that they would rather not have because they were avoiding thinking about such things. Also, too many people have been kept alive when they would rather not have because their family or certain family members were not ready to let go. Planning doesn’t take the painful emotions out of dealing with EOL time for family members but it absolutely takes out the guessing of what the patient wants. At least a patient can be more at ease knowing that their wants and wishes are available to the health care professionals and their families and hopefully the families can be more at ease like Susan Jacoby said she felt in the article.

  4. I agree that advanced directives are a necessity and a responsibility that everyone should consider ahead of time. I find the statement you made interesting about it being impossible to know if someone will change their mind when facing death and you mention this is why it is a debated argument whether to do advanced directives or not. Remember that the directives are always revocable at any time if the patient changes their mind. People really do have the power to overrule the doctor’s decision but some elect to only take the doctor’s advice thinking the doctor knows everything. The doctor only “recommends”, and the patient always decides -based on those recommendations.
    So in light of that, people do not do advanced directives for many other reasons too. Many people hesitate due to the vagueness of the medical procedures that might arise. It is impossible to cover every circumstance. Yet there are basic guidelines to follow such as respirators, dialysis, feeding tubes, antibiotics that prolong death etc. I think these things should be decided by every single person before illness strikes. At least this gets a person to confront the issue. So much effort and money is spent trying to keep people alive when some of them may not want to live under the conditions they are faced with. Advanced directives could prevent some of these situations.

  5. Human as we are, the will to survive is our strongest instinct. Due to this reasoning, human beings might have made rational decisions in regards to something earlier; or believed that they would be able to make a rational decision in a threatening situation that demands so – but when actually facing a situation as such, even wisest have been known to make the most foolish of decisions.
    You raise an excellent point that we, as a society, shouldn’t be afraid to make decisions regarding death soon: it’s never too early. More people should be recommended to do advanced directives and living wills, regardless of their age, so once they have something that is kind of almost set in tone, or authorized, it would prevent people to “immediately” change their response emotionally, when facing a life-threatening situation, and actually reconsider the initial decision they had written down on paper.

  6. I agree with your ideas here. No one really thinks about what will happen at the end of their lives. In some ways I think we all assume we will be free of cognitive impairments and able to make rational decisions at the end. This may not always be the case though. Because there is always that uncertainty, it is so important for people to make know their preferred methods of treatment before anything major happens. Although it is not something we want to think about, having a document that says we don’t want to be on life support would be much better than having painful and costly procedures done because the healthcare provider is uncertain about our wishes. It could also save families from harsh disagreements, which is the last thing anyone needs in the final days of a loved ones life. Great post!

  7. I have to agree that it is because of the death denying way that causes so many problems with the decisions that must be made at the end of a family members life. If everyone had an advance directive doctors would know what to do and families would not have to go through the burden of having to make the decision. I feel that many people never want to fill out advance directives because they think they wont need it, or it takes lots of power and strength to fill one out, or when they are in that situation and they need one but by then it is too late. I feel like if people started planning ahead, we probably would not be considered a death denying culture as much.

  8. I completely agree with your stance that America is a death denying culture and that it is important for people to have an advance directive so that medical personnel and family know a patients wishes if they are unable to relay those instructions themselves. Nobody knows what may happen in the future so it is important that we stay prepared in case a situation arises where a pivotal decision must be made. It may be a hard reality to face because death is not something people prefer to talk about, but it a hard truth that we must face. By consulting health care providers and physicians this process can be easier because advice can be obtained on the proper steps to take.

  9. It’s very true how you related this article to the United States being a death denying culture. In every aspect of what we talk about/blog about this is exactly this concept. I really like how you brought it back to this notion. I also agree that their should be some form of written document of a preferred method of treatment, maybe even needed in order to begin receiving treatment. I really like how you said it should be done with like a primary physician so that way they physician can also account for what the patient wanted if the family decides to not agree with them. But, this paperwork should more of a guideline, so as if something different may occur, one would at least understand the basis of what they wanted.

  10. I completely agree that having an open discussion with loved ones before a person gets to the point where they can not speak for themselves.This would eliminate so much confusion about what a person might have wanted. Letting others know what a persons EOL decisions are also ensures that those wishes are carried out. I liked how you included a physician to be in those conversations when talking about EOL. Other people that should be told of these decisions are trusted friends and family. You want to make sure that people that you would include in to these types of conversations are people that you trust to make sure that your wishes are carried out. But of course the best way to solve this issue is to have it in writing and witnessed by the appropriate people.

  11. Whenever you make a decision in life, you should never ever base it off of emotions. Despite this age-old advice, many people wait until the last minute to make a decision. Often than not, these decisions can be extremely ill-prepared and irrational. This also applies to issues dealing with end-of-life events. Just as you stated, instead of making decisions when the time of death is near, it is more reasonable to prepare for this event beforehand using resources such as advance directives and living wills. This fear of death which surrounds our death denying culture prevents many people from planning ahead. If individuals take responsibility now, there would be less confusion and anxiety on the medical staff and on the family of an incompetent patient.

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