Regarding end of life and the decisions made at and about that time, I feel that one has many responsibilities. The first is to themselves. Only you know how you personally feel about receiving life sustaining treatment, when its appropriate to continue and when it is best to stop. Knowing this, you owe it to yourself to ensure that your wishes will be respected and followed. There is also a responsibility to consider family when making these decisions. The family is already going through the stress and trauma of potentially losing a loved one at this time, and the stress of making EOL decisions or fighting over them does not need to be added to their burden. This doesn’t mean that family cannot be included in these decisions, that is encouraged. It just means that they should be taken care of ahead of time to reduce stress later.
When it comes to a family questioning a health care provider, I think that is essential. While the care provider has a better understanding of the medical side of EOL decisions, they don’t have as strong of an understanding of the individual, their feelings and beliefs, and the family itself. The family’s questioning of the provider and their treatment can ensure that all of the patient’s needs and wishes are met, not just the medical ones. Also, I think that sometimes physicians are so concerned with saving the patient and fighting illness that they can fail to see the futility of their own treatments. The individual and family may see this futility and can spare additional suffering and expenses by questioning and refusing treatments. There is also another unfortunate reason why the family should be able to question a health care provider, and that is because some may not have the patient’s best interest in mind. They may order more treatments, more tests and more medications in order to seek additional payment and reimbursement. While I think that it is the exception, this type of activity does happen and is something else to consider when discussing the ability to question a doctor’s orders.
As part of a death denying culture and just as a living person, it is natural to fear death and the subjects surrounding it. But on so many heartbreaking occasions, this fear has kept someone from preparing advanced directives. Discussing advanced directives with loved ones and completing them early is key as it helps them fulfill the responsibilities they have at the end of their life.