You need a living will …

Yesterday, I defined some of the different terminology used when discussing end of life decisions.  Tomorrow, I am going to highlight the important issues that you have to consider when writing an advanced directive or a living will.

Today, I am going to tell you why you should sit down, pour yourself a big glass of wine, face the fact that you will not live forever and think about how you want your final act to play out.  Warped as it may be, I am reminding you of your own mortality because I care.

1.  Your family loves you – If there comes a time when you are in a vegetative state with no hope for a recovery, the last people you want making decisions are the people who love you most.  Their judgment is clouded with grief and false hope.   In medical school, after my first time seeing a patient in a coma, I immediately sat down with my husband, then boyfriend, and filled out the forms to make him my health care proxy.  I knew my parents would leave me in a coma forever but this guy would probably want to move on quickly.  Sad, but true.  I would’ve done the same for him.

2.  You love your family – One of the gifts that my wonderful mother gave her family during her final days, was making all of her wishes known.  It left no room for discussion or argument.  It gave us a sense of peace at the end that we were able to follow her wishes.  I have seen families fight and cry and torture themselves over decisions that are really not theirs to make.  They have all but begged me to tell them what to do but legally and ethically, I could not.  So, if you love your loved ones, let them know exactly what you would and would not want done at the end of your life.  Better yet, write it down so their is no room for interpretation.  In their grief, they will likely not be equipped to digest all the medical information they will be receiving and will be forever ridden with the guilt of not knowing if they did the right thing.

3.  You don’t love your family and you suspect that they don’t love you – In this case, you’d better write your wishes down today.  Their judgment will be clouded by revenge and the possibility of an inheritance and you definitely don’t want them determining your fate.

4.  Unfortunately, most people don’t die in their sleep – There are lots of opportunities to end up brain dead – stroke, heart attack, drug overdose, watching a lot of reality TV, car accidents, and sports injuries to name just a few.  You have fire and flood insurance and you don’t really think either of them are going to happen.  Think of a living will as an insurance policy – something that you hope you don’t ever need, but know you should have nonetheless.

5.  To maintain your dignity – Have you ever been in the hospital, wearing a gown that is open in all the wrong places, feeling your most vulnerable?  Now imagine being unable to communicate and being gone in all the ways that matter, but being kept alive by modern medicine.  Give yourself a voice just in case this happens.  Be there on paper to remind everyone that you are still a human being, in charge of your own body, with wishes that need to be adhered to.

I just reread what I wrote and it comes off a little strong.  Sorry, but it’s only because while my opinions may be wrong in other areas, about this, I am certain that I am right.  I have watched people die and the sad truth is that we all die alone.  Your family will be able to do very little to help you, but by making your decisions now, you can help yourself and you can help them — think of it as a going-away present.  This is so depressing.  I have to go check if I have the makings of a martini in the house – wine might not cut it tonight.

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