Living Wills/Advanced Directives

Information on Living Wills/Advanced Directives from Vaisnavas C.A.R.E.
October 13, 2006

Submitted by Jusaniya devi dasi (Judy Harris RN, BSN, Hospice Nurse)

What medical interventions would you want done if you suddenly suffered a stroke that left you brain-damaged and unable to swallow? Would you want physicians to provide you with artificial nutrition through a surgically inserted feeding tube? If you were injured in a car accident and unable to breath would you want doctors to place you on a ventilator to breath for you? What if you had a severe heart attack and stopped breathing? Would you want to be resuscitated?

These scenarios occur every day to people around the world bringing to our attention the issues of end-of-life care and life-sustaining medical treatment. If one of these tragedies happened to you, would you be prepared to let your doctors and close family members know what you would want done (or not done) if you were unable to speak for yourself? Without having a written document to speak for you your family would be faced with some very difficult decisions. But, if you have prepared a Living Will, making your wishes known in writing, the burden of making such decisions would be lifted from your family and you would receive the exact care you wanted.

Briefly stated, a Living Will is a written record of your wishes concerning what life-sustaining medical treatment you would want (or not want) if you were ever unable to make these decisions for yourself due to an accident or terminal illness. It is a legal document that is signed, dated and witnessed (and notarized, if required in your area) and serves as an advanced directive should you be unable to express your desires at the time such treatment might be administered. Not all countries recognize a living will or have laws that pertain to such a document. For those of you who live within the US you should be aware that every state now legally recognizes a living will, however specific requirements do vary from state to state. Advanced directives are not meant to limit medical treatment, but are meant to speak for you if and when you are unable to do so yourself. A living will protects your right to die with dignity. It assures that treatment will be limited to comfort measures and pain management, including any discomfort that might occur as a result of withholding life-sustaining treatment.

Every Living Will is written differently. Some state one’s wishes only in the case of a terminal illness. Others state what a person would want done (or not done) if he/she were in a state of permanent unconsciousness, as in the case of a serious accident, for example. A Living Will usually contains a list of interventions for you to choose the type of treatment you would desire or not desire. Some examples include the following:

1. I do/do not want cardiac resuscitation (including CPR and/or chemical resuscitation)
2. I do/do not want mechanical respiration (to be placed on a ventilator for breathing)
3. I do/do not want tube feeding or any other artificial or invasive form of nutrition (food) or hydration (water)
4. I do/do not want blood or blood products
5. I do/do not want kidney dialysis
6. I do/do not want antibiotics.
7. I do/do not want intravenous (IV) medications

Most Living Wills include a space for the patient to designate a Medical Power of Attorney (POA). The POA designates a third party—a family member or close friend, for example—to make decisions for you regarding your medical care. This person is entrusted to review your medical condition and to make decisions about your care based on their understanding of your wishes. The Durable Power of Attorney for Health Care speaks for you and becomes effective only when you are unable to speak for yourself. Every state/country has its laws, but it is recommended that the POA be a competent adult at least over the age of 18 years old. Some Living Wills allow for an Alternative POA should the Power of Attorney be unavailable or unwilling to make medical decisions on your behalf when the time comes.

In The Final Journey—Complete Hospice Care for Departing Vaisnavas by Sangita devi dasi RN, CHPN (Torchlight Publishing) there is a copy of a Living Will written by Kusa dasi, a senior disciple of Srila Prabhupada that is specifically written for Vaisnavas. In addition, your healthcare practitioner or local hospital should be able to provide you with a Living Will/Advance Directive. Whichever document you choose to use, we recommend that you consult with a lawyer who is knowledgeable in this subject matter and the local laws as it pertains to these documents.

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