As they get older, most doctors don't want chemotherapy or risky surgery to save their lives. Doctors are all too familiar with what goes on at the end of life, especially what they see in intensive care. They see the suffering that results from procedures, medications and tests that people choose so they can buy a extra few months of breathing. Yes, I said breathing, not living. What people go through when they die in ICU is not what anyone wants to think about when they think about living. While most of us avoid it, physicians have spent their careers thinking about what they want at the end of their lives. They see what they don't want done and are very explicit about it with their families.
Here is a well-written article is by a physician on this topic: http://www.saturdayeveningpost.com/2013/03/06/in-the-magazine/health-in-the-magazine/how-doctors-die... I urge you to click on the link and read it. Having worked in and around intensive care units for over thirty years, I agree with everything he says.
Please give this stuff some serious thought and discuss it with your family. Here in California, our Advance Directive form (http://ag.ca.gov/consumers/pdf/AHCDS1.pdf) includes both a Power of Attorney for Health Care and End-of-Life Decisions on the same document. The power of attorney is where you say who you want to make medical decisions for you if you can't for some reason. The End-of-Life Decisions is where you indicate what you would and would not want done and under what circumstances. There are instructions on the forms about how to fill them out and what to do with them. But even after you complete the process, it can be difficult to see that your wishes are followed.
When you've decided what you want, make sure that you get your family to agree with you. I can't tell you how many times I've had a patient who knows what they want but a family member convinces them to do the chemo or surgery. The patient changes their mind to appease the relative. THIS IS WRONG AND IT'S CRUEL FOR YOUR FAMILY TO DO THIS TO YOU. It about their fear of losing you, not about loving you. If your family tries to pressure you, ask them point bank. No one who loves you wants to make you suffer for the last weeks or months of your life, do they? BE FIRM. BE STRONG. BE YOURSELF.
I'm a patient advocate and I'm here to help.
Dale Alexander holds a Certificate in Patient Advocacy from UCLA, has served on multiple Ethics Committees and has taught Medical Ethics at St. Mary's. She can be reached at 707.319.5856 or emailed at dale5657@gmail.com.
