Medical Decisions and the Hospice Patient

There are a number of decisions a hospice patient and their family members may be called upon to make. While family members may offer advice and opinions with regard to medical decisions, ultimately it is the patient’s right to decide. Some of these decisions may involve estate planning documents including a will, a Durable Power of Attorney and a Declaration of Guardianship.  Also included will be the designation of a Power of Attorney for Health Care and a Directive to Physicians.

Of these the Directive to Physicians, also known as an Advance Directive or Living Will, is often the most difficult decision for the patient to make. This document allows the individual to state that, in the event they have an irreversible illness and further treatment would only serve to prolong life, but would not make the quality of life better, you would want the life-sustaining machines to be removed. Under a Directive to Physicians, the person is not giving authority to another person to make the decision to unhook life support systems, instead, you are making that decision through signing the Directive to Physicians.

Most persons, even those with a terminal condition, will often have such a strong will to live that this document is the most difficult to agree to. Perhaps a person will cite “what if” scenarios to reject or delay signing the document. Even though the individual may acknowledge the preference not to be “hooked up to machines” they still delay executing the document. Sometimes they delay to the point they are no longer able to make the decision and sign the document and the family is left with the decision to make.

When we think about doing what is best for ourselves and loving for our families, this is a decision to seriously consider. It is not an issue of “giving up” but living life well. These are individual decisions each of us should be willing to make for ourselves and our loved ones.

Steve Horton, LBSW