This story illustrates the difficulties families deal with when confronted with complex healthcare decisions. The article emphasizes the need to create advance medical directives to help family members of patients. These end-of-life instructions should be in a legal document, prepared by an estate planning attorney so that it satisfies the requirements of state law. The directives should include:
- A Healthcare Designation. This is a very critical part of an advance directive, as a “healthcare designation” or “healthcare proxy” names an individual you authorized to make medical decisions for you, if you are unable to do so on your own. This friend or relative is given what is also called “durable healthcare power of attorney (POA).” This allows them to speak on your behalf.
- A HIPPA Release. This allows your proxy to communicate with your healthcare providers about your care.
- A Living Will. This formal statement communicates your wishes for medical care should you end up in a “persistent vegetative state” with little or no chance of recovery, and you can’t communicate your wishes. Talk to an estate planning attorney as every state has its own regulations for living wills.
- Treatment Restrictions. You should spell out exactly the circumstances under which you would want to have life-sustaining care or when you want to pass, many times with only medication for pain. Distribute copies to your doctor, family members, and (if appropriate) close friends. The article lists several specific treatments you might want to address:
- A Do Not Resuscitate (DNR) Order. This states that you do not want providers to perform extraordinary measures (like CPR) if your heart or breathing stops.
- Mechanical Ventilation. State when and for how long you would want a mechanical respirator to take over your breathing.
- Nutritional Assistance. Discuss your feelings about nutrition if you could only be fed through an intravenous or stomach tube.
- Dialysis. Kidney failure can be the first step toward death in terminal patients. State parameters around which you would want this treatment.
- Brain Death. State what you would want if your brain function was deemed minimal or immeasurable.
- Organ Donation. Make your wishes known if you want to donate your organs and tissues for transplantation.
It’s no shock that end-of-life planning is a difficult topic to discuss. Just 26.3% of Americans have completed advance directives, according to a 2013 study. But as the Bobbi Kristina Brown case shows, it’s important and never too early to discuss this topic with spouses, family members, partners, adult children, and parents.
