Responsibility at End of Life

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.

EOL Decisions

The end of life stage can be very stressful for all parties involved. Every American should be responsible to make their own decisions on what they prefer during this stage. This will alleviate unnecessary stress during an already terrible time. Most people seem to be unaware or avoid end of life topics because of the taboo nature. However, as society we tend to embrace having the power to make choices and that should include choices of medical treatment and funeral arrangements during the last months of life. Making decisions before hand and having things prepared is a smart option.

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The responsibilities should include what treatment they would want in various scenarios like acquiring dementia, becoming brain dead or any terminal disease like cancer. This will allow the family to solely cope with what is going on with their ill loved one instead of worrying about the un-made medical decisions. It would even be helpful for a person to have funeral arrangements set up before the time comes.

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This may tend to freak a lot of people out, but if you think about it you are really the only one who knows exactly what you want. I know I definitely do not want to be buried but I have never expressed that to anyone. If I were to die tomorrow (god forbid) I’m sure the general consensus would be to bury my body because my request has never been given. After the death of a loved one many families may feel regret of the decisions made. Questioning whether or not the correct decisions were made during the end-of-life phase happens. I witnessed this when my mother had to decide to take my grandmother off of life support after a car accident. With her having to make such a huge decision it definitely had a negative affect on her coping process. I think responsibilities should go past advanced directives, living wills, a legal proxy, etc. As taboo as death and end of life is it needs to be talked about- it is our responsibility to talk about it.

The patient should die as they please and the family should be there for the loved one during the time of need. The family should watch over the loved one and ensure everything is being carried out by the medical professionals as the patient requested. Healthcare providers, just like anyone, can make a mistake or over look something. We are all human and things don’t always happen as they should. If the family or patient feels as though they need to question the provider they should do exactly that. Just because they are expected to be the experts does not mean the patient and family cannot have enough knowledge to think another option may be more suitable.

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Susan Jacoby’s argument is precisely correct. If more Americans would break the contradiction and make end of life decisions earlier on it would make this life phase much more bearable for everyone.

Responsibilites at End of Life

 

End of life decisions are things that most people do not discuss in their everyday conversations. People tend to wait until they are in a situation that calls for such a conversation. The problem with this is that sometimes people aren’t sure what they want and don’t have enough time to process their situation fully. The American people have a right to make these decisions, but they sometimes do not want to because they are faced with very difficult questions. In the end, Patients need to make their own decisions. It is perfectly acceptable to consult family or a doctor in order to help in a situation that concerns end of life.

The families in the patient’s life are just as important because they need to be there for the patient and help them to come to terms with their situation and to console them. Families are also sometimes used to make the difficult decisions when patients aren’t capable to do so for themselves. Families also need to make sure that the patient is being taken care of in the best way for their best interest.

If a family or a patient ever has questions, they should always ask questions. I feel that the more questions asked by the patient to the doctor, the better. If someone asks questions, the doctor is more likely to give more information and respond better. I’ve seen through personal experience that doctors enjoy teaching. Even my grandmothers’ cancer doctor loved when we would ask him a million questions because he felt like we really cared and wanted to know as much as we could about the procedures and her condition. (She is now cancer free for 4 years and doing very well, in case you wondered) I feel like questioning a doctor and making sure he is doing what is best for a patient is always the best decision.

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Who’s death is it anyway?

“Death is one of two things. Either it is annihilation, and the dead have no consciousness of anything; or, as we are told, it is really a change: a migration of the soul from one place to another.” -Socrates

I believe Americans have a responsibility to make their own decisions regarding end-of-life preferences. Yes, thinking about end -of-life decisions is overwhelming, but burdening your loved ones could cause controversy among the family, devastation, and financial implications. Loved ones may disagree and argue about what treatment you receive and that could destroy their relationship. They also may suffer by watching you suffer and they could be left paying pricey medical bills.

Americans fought for certain rights and freedoms for hundreds of years. To neglect the right you have to choose your end-of-life decisions would be foolish. You spend your life fighting to be successful and achieve happiness, so why lay on your death bed with no dignity and no chance to choose how you die. Also, you make decisions every day, some decisions you make are not even important, this decision is. You are blessed with the opportunity to choose what type of healthcare you receive, what type of treatment you want and do not want, and how your body should be disposed of, why waste it?

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Your wishes may change over the course of time. They also may change when you are actually lying on your death bed. Whatever your wishes are, I believe it is very important to have them documented in a living will. It is also important to discuss in depth exactly what you want with your children, healthcare proxy, and your healthcare provider. Your loved ones should know what you want because it will be difficult for them to decide for you if there comes a time where you are incapable of making your own decisions. Also, your loved ones have the right to know what you want and why you want it so they could be at peace when you pass. For example, they may not have closure if they are unsure that the decision they made for you what something you wanted. When your loved ones let you go they should be able to move on knowing this is what you wanted and this is what you are happy with.

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Your loved ones may not understand a health care provider’s reasoning for certain treatments as well. Patients and their family members should be able to ask questions. Patients and their family should know if their illness is irreversible because it will help a patient determine what their next move is. Also, they should question the decision of a healthcare provider because if they do not understand the doctor’s terminology they might be agreeing to something that they realize is not best for their dying loved ones.

Blog #3

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         I like to describe our people and society as a very stressful lifestyle. In many cases we tend to let meaningless tasks get the best out of our emotions when their not actually harmful to our health. Since that there are so many little stressors that we come across daily, I believe that we tend to put the most stressful situations behind us to deal with later. Amongst some of those heavily stressful events, the most stressful one that I could imagine would be to have to face those deadly medical occurrences for me and my family.

         Although it is a responsibility to take care of my own medical “end-of-life preferences”, the decisions that I would have to explore to make would be those that I would consider to be of greater stress. It is our responsibility to make our own medical preferences but nobody wants to go through the mental process to make those decisions. Although it may be our duty to make our own medical decisions, we cannot forget the fact that if it wasn’t for technology we wouldn’t have to make so many interventional decisions. So, whether technology has actually helped or hindered our decisions for medicine will always be a relevant question to consider.

            Regardless of what opportunities we are presented with that could possibly save our life, it is always the individuals view on what is actually humane to do. Everybody’s outlook on autonomy is different for each individual, while some people have the same views other people will have different views. At the end of the day, as long as the patient is able to communicate, it is the patient’s decision and authority to make his or her end-of-life procedures. If the patient is unable to make his or her own decisions then the family should be responsible for doing so. Although the medical decisions for a loved one places a big burden on the family, the family has to be able to live with what happens to their family member, so why shouldn’t the family have that responsibility to decide what happens when they are presented with all of the outcomes possible? With that being said, they should have the opportunity to question healthcare providers. I know that personally, if me or my family were to question a healthcare provider, it would be based off of personal family and cultural beliefs. Irma Broderick Jacoby made a living will but that was because she already had her own preconceived beliefs on what needed to be done

            At the end of the day, my personal outlook is that at any given time whether a family or the patient knows extreme amount of information or knows nothing, they should always know enough to question the doctor because when it comes down to the very end-of-life only the patient and the family know what is truly best morally.. 

 

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End-Time Responsibilties

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Any person has the responsibility to make their own decisions regarding end-of-life preferences. The problem, as Susan Jacoby stated, is that

“In a Pew Research Center poll released in 2006, only 22 percent said a doctor should always try to save a patient’s life, while 70 percent believed that patients should sometimes be allowed to die. More than half said they would tell their doctor to end treatment if they were in great pain with no hope of improvement.”

This statement actually points to the fact that no one actually does want to take responsibility for their end of life decisions. I assume that this has something to do with being afraid or nervous to discuss such things. In all honesty, I am one of these people. I find advance directives extremely important since I have learned about them in class. I am one of the people who “just don’t have the time” to write one up. I am educating myself about different treatments and what they mean before I make any decisions. That being said, people have the responsibility to make sure that their next of kin know what they want should any thing happen to them. Too many people have been kept alive on artificial nutrition, hydration, and ventilators against their will, but they did not take the initiative to ensure otherwise. Families who are unsure of the wants and desires of the loved one they are answering for are surely in the most unsettling of situations. Luckily, my mom has told me over and over again to pull the plug if there is no hope of her getting better, cremate her, and spread the ashes somewhere in a body of water. As for my father, he has a spouse so I really need not worry too much. My responsibility to my mom is to make sure her wishes are met. That is the responsibility of any next of kin. In the case that the next of kin does not know the wishes exactly, they have to do what they think is right. The problem is that it’s really a guessing game. Though a patient and their family may not “know enough” to question the decision of a healthcare provider, they should still ask questions. No question should go unasked in fact. Knowledge is power and how is one supposed to know what to do next if they don’t know what they’re dealing with? A patient and their family should also know that they have the right to a second opinion. The first step is education. After one is armed with the facts, then come the advance directives.

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End-Of-Life Decisions: Planning is Key

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            American’s have every right to make their own decisions about their death. In Susan Jacoby’s article, her mother had everything planned for her death and her mother knew exactly what she wanted. Fortunately for her it made her death more comfortable and easier to cope with. Yet, unfortunately for other Americans, they don’t discuss their possible end-of-life stage and it could lead to confusion for the family that is involved.

            The responsibility of the patient and the family is to know what they want in their end-of-life. As stated before it makes the dying process easier to understand and easier to cope with when the dying and the family understand what they want and are in agreeance. Patients and their family play the role of making the final decisions and supervise the situation as a whole. For example, if the dying cannot make competent decision its the families responsibility to understand what the patient wanted done. If the patient had an advanced directive, it is the family’s responsibility to be able to interpret it and follow the wishes of the dying.

             Unfortunately, the patient or their family may never understand enough to question what the health care provider is deciding upon. On the other hand, it is still the health care providers responsibility to inform the patient and their family what procedures are going to be done and whether or not it will be futile. Every patient should question what the health care providers are doing to them, it is their body! If the patient lets the healthcare provider do what they please, they make kick into “I must save every patient mode” and do unnecessary procedures that may prolong their dying process. Who wants that done to them? Every American has the right to make decisions on their end-of-life. To die with dignity is the only way to die.

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Blog 3: Taking responsibility for death

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Making an end of life decision can be hard since death is a taboo subject for most people, however, it would be beneficial for everyone to plan out their end of life preference. Advanced directives are easily available and should be utilized to avoid conflict within the family or with the doctors. Having someone else make all your medical decision can be difficult for them because they may not know what you would have wanted, therefore family members should have this conversation as soon as possible and make sure advanced directives are completed.

Families hardly ever agree on anything, like the family throwing a coffee pot at each other over conflicting opinions because no advanced directives were filled out. However, if the entire family got together before rash decisions were made, it can make the end of life process easier by talking about end of life decisions and filling out advanced directives. It is the patient’s responsibility to make it clear what treatments they do or do not want and it is the patient’s family responsibility to make sure those wishes are carried out. The family could then support the wishes of the patient, even if it was hard for them to do so, and find comfort by knowing exactly what the patient wanted. For example, my mom has told me if the time ever comes to where there is no hope for her to recover to the life she had, then she said let her go peacefully just like Susan Jacoby’s mother from the article wanted. She did not want all those invasive procedures and medical bills if there was no treatment to get her back to her health. On the other hand, my step-father said he would want all of the treatment possible because he believes he has what it takes to overcome any life-threatening disease or trauma. By having this conversation, I am better suited at determining what my family would want if a decision was to be made.

Although the doctor’s job is to explain procedures and give alternative treatment options to the patient and family, I think a patient or the patient’s family can know enough to question a decision made by a healthcare provider. Most people want to believe that their doctor’s advice is the only “right” answer, but getting second opinions from other doctors, if you have ample time, would be a good idea to do because it never hurts to ask. Also, doing your own research could be beneficial by making you more aware and knowledgeable of the situation such as what possible treatment options are available and how invasive they are. Questioning a healthcare provider may do you some good if you want to provide the best care to your family or to yourself and not end up with expensive medical bills. It is the responsibility of every American to make their end of life decisions and take the burden off of their family members.

Taking Responsibility for Death

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              End-of-life decisions are never easy to make. They require strength and a lot of thought to it. Americans do have the responsibility to make their own decisions regarding end-of-life preferences. They all have the responsibility of deciding what kind of treatments they want, or if they even want treatment at all. Life has many obstacles, which may include being diagnosed with terminal illnesses, or getting into accidents that end up getting people into hospitals with machines keeping them alive. Therefore, advanced directives are very important to have for doctors and family members to know exactly what patients want regarding resuscitation or treatment options. They provide a huge comfort for families because they do not have the burden of deciding for the patient. Furthermore, it is very important for people to be sure of their decisions, and to be explicit about what they want, in their advanced directives.

               The role of the patient’s family is to support their loved one, and be strong for him/her. Family members are there to help the patient make good decisions, and make sure every procedure in hospitals are done correctly. Unfortunately, family members have the burden of deciding treatment options because many Americans do not have living wills that dictate their preferences while unconscious. Susan Jacoby wrote an article regarding the responsibilities of people for end-of-life preferences. In her article she talks about her dying mother. She tells the reader that it was a huge comfort for her to know exactly what her mother wanted. After reading this, it is important to realize that advanced directives are a good idea to avoid being a burden to family members when it comes to making difficult decisions.

                Healthcare providers are always there to help the patient understand their options and the details of their diseases. Their job is to provide the best explanation and to suggest different alternatives. However, nobody is perfect. Sometimes, healthcare providers do make mistakes regarding treatments, since it is very difficult to know how a patient will react to the different medicines. Therefore patients and family members may definitely question a healthcare provider and their decisions. Sometimes second opinions may be a good option, because end-of-life decisions are not easy. Neither patients, family members, nor healthcare providers will ever know enough to choose a perfect treatment. There is no perfect medicine or treatment; but that is why you have to gather enough information from different doctors, and trust God, who will always be there throughout every process and every hard decision. 

                Decisions are part of life. Some may be easy decisions, but some may be very hard ones. Either way they have to be made. End-of-life preferences are difficult not only for the patient, but also for family members. Advanced directives are definitely a way to make things easier, even though they still require a lot of thought. However, these documents can make a huge difference during these situations for healthcare providers, families, and patients. Americans should all be responsible for their own death. 

Taking Responsibility

Taking Responsibility

Everyone agrees that when the time comes they want a “good death”. This doesn’t magically happen, it takes planning on the part of the patient. Making end-of-life care choices is one of the biggest, most important decisions in a person’s life. It is the patient’s responsibility to be proactive towards treatment they do or do not want to receive. Only after being fully informed about the diagnosis, prognosis and treatment options will they feel more in control.
Americans plan everything in their lives from schools, careers, weddings, vacations and retirement but avoid plans for end-of-life. The reasons for this range from being too busy, not wanting to talk about death and dying and just putting off things that are unpleasant, thinking you’ll deal with it tomorrow. The most valuable tools to have in place for end-of-life care are Advance Directives. These include two types of documents, a Living Will and a health care power of attorney. A living will allows an individual to refuse life-sustaining treatment in the time they are terminally ill. A healthcare power of attorney covers all health care decisions, and lasts only as long as you are unable of making decisions for yourself. A responsible person doesn’t leave this these decisions until crisis strikes and they no longer are able to communicate their wishes. This is an emotional time for spouses, adult children and siblings. It is also difficult to figure out exactly what the people they love would have wanted. It is the family’s responsibility to talk about such things as;
• what medical treatments and care are acceptable
• do you wish to be resuscitated if you stop breathing or if the heart stops,
• do you want to be hospitalized or stay at home.
Discussing how your care will be paid for and if there is enough insurance should also be brought up. A trusted person should know where all the important documents are; insurance- medical, long-term care and life policies. Instructions should be written out for the funeral, burial or cremation choices.
Being honest and open with the physician is key. The doctor must honor the patients’ wishes or else transfer their care to another doctor that will. Getting second and even third opinions from different doctors is another way of taking control of your medical care. Having complete knowledge of what’s in store is the only way to make responsible decisions. Making sure the health care provider is on the same page when it comes to the physical, emotional, psychological and spiritual care of the patient will ease the dying person. Knowing that medical decision making is a process which allows changes throughout care.
Death is such a taboo in today’s society. For this to change people must get thinking and talking to their family and doctors. This will give the patient a voice, health care providers clear ideas about choices at the end-of-life and comfort to the family that they have no doubts about what their loved one wants. We must all take responsibility for ourselves.