Sunday, July 13, 2014

ADVANCE DIRECTIVE

Several years ago, maybe because of some rerun of the 1990 Schiavo controversy, I decided to make my feelings about end-of-life medical care known to my family. The Terri Schiavo saga is told HERE,  including news videos at the time and some political decisions that were made as a result of the conflicting views by members of her family.  

I already had a living will and a durable power of attorney in addition to my will, but none of these documents defined specific decisions about end-of-life medical treatment.  At that time I had not listened to the Radiolab interviews, and I didn't know about the changes made to the Georgia laws in 2007.   

As a precursor to any information about documents, I turned to the Radiolab  program  as an introduction. The link to it is in last week's post as well as HERE.  (About twenty minutes long and you'll know within five whether you want to listen now.)

ADVANCE DIRECTIVE FOR MEDICAL CARE


The Advance Directive for Medical Care may be more effective if a person's choice is to use anything possible to sustain life.  After listening to the doctors on the Radiolab interviews, it is wise to assume that those doctors may be in personal conflict about this issue.  Other doctors may have no conflict at all. If your wish is to remain alive as long as possible and you become unable to articulate that fact, the statement in your Advance Directive makes each decision of your medical team easier and you are likely to have all of your medical wishes fulfilled.  If your wishes about care are otherwise, the same is true.  Your written instructions and your personal agent are there to make sure your directive is followed.

In Georgia, it is possible to download documents from the Human Resources Department.  You can use a link HERE, or do a search for Georgia Advance Directive. A search will lead you to  documents including changes, instructions, and a form to fill out, produced by the Georgia General Assembly   "to help reduce confusion, inconsistency, out-of-date terminology, and confusing and inconsistent requirements for execution."  

If you do a search for the documents you will find them in PDF, DOC, etc. formats.  The documents spell out the effect of the Georgia Advance Directive for Health Care Act (2007) on the Georgia Living Will and Georgia Durable Power of Attorney for Health Care laws, which  it replaced.  If you have acted on the previous laws, I believe they remain in effect until you change them using the new material, but for accurate, up-to-date information, read the first section in the instructions online.  It explains the differences and the current law.  The instruction document also includes suggestions about how to initiate discussions about the topic to your family. 

Although the form is a well-worded document, simple and straight forward, I still found it necessary to change the wording in some sections. The new law does NOT require the use of a lawyer or a notary, but if you prefer to have legal advice, it would be an easy thing to do.  

USING THE COMPLETED FORMS

After doing the paper work, I asked our family to get together to go through the documents, using the suggested material. The document allows you to name a health care agent to see that your wishes are carried out.  Mine was my daughter, our oldest child, who died in an accident last October. It is impossible to make an Advance Directive final.  We don't know what will happen to any of us. My son will now have to be agent for both of us. The instructions suggest frequent reviews, signed and dated by the document's author.  The idea of age being relevant here is irrelevant.  Terri Schiavo was 26. 

The documents can be sent to hospitals and doctors and lawyers, but probably sufficient is that family members know of your wishes and there is no expectation of conflict among them.  Also, if your lawyer has copies of your living will and durable power of attorny, those documents should be replaced only if you have decided to use the Advance Directive.

There is no magic - nor vision into the future.  The odds are what they are, and it is in our best interests most of the time to be thankful that doctors take that Hippocratic Oath.  We should help them make the hard decisions by leaving them with an Advance Directive for Medical Care in the event that we are unable to discuss and decide on our medical care issues

THE HIPPOCRATIC OATH

If you are curious about it, this  NOVA site presents the original Hippocratic Oath and modern revisions, as well as doctors' and non-doctors' comments. Interesting!  You can find it HERE.

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Cut and paste here for any of the relevant web sites.

The Terri Schiavo case: 
http://www.nytimes.com/2014/04/21/us/from-private-ordeal-to-national-fight-the-case-of-terri-schiavo.html?_r=1


The Radiolab interviews:
http://www.upworthy.com/the-way-doctors-think-about-death-is-pretty-different-from-the-way-their-patients-do?c=upw1

Department of Human Services article describing the changes in the laws, published on October 16, 2007 http://dhs.georgia.gov/new-georgia-advance-directive-healthcare-replaces-living-wills-and-durable-power-attorney

Forms: Perform a search on 'Georgia advanced directive' and select the format you want. 

The Hippocratic Oath, original and recent:
http://www.pbs.org/wgbh/nova/body/hippocratic-oath-today.html

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If you want more radiolab programs, look here:
http://feeds.wnyc.org/radiolab