WHO DECIDES–THE MEDICAL COMMUNITY?
The mission of the medical community is to save lives. For them, death is a defeat against which they work tirelessly. How can we not applaud them for the diseases they have defeated, the accident victims they have saved, and the health care most Americans enjoy? When we are sick, we seek the advice of our medical professionals and rightly so. When we face a terminal diagnosis, however, their curative approach may not be the best one. Since we are mortals, there is a time to die (Ecclesiastes 3:3).
This is the subject of Being Mortal by Atul Gawande, a book I previously reviewed. https://finishlifewell.org/being-mortal-what-matters-by-dr-gawande. When it is almost time to go to the Father, how do we want to spend our days—enduring medical treatments or enjoying our loved ones? Dr. Gawande gives us some wonderful questions to help us negotiate these high stakes decisions. One key question is—Do we see our doctors as the decision-makers? OR Are these highly trained professionals offering us options and information?
Without thinking it through, some of us abdicate our decisions. We pursue every medical option until life is artificially maintained. It is the underlying condition, not the removal of life support, that actually causes us to die. Even so, giving a loved one the God-sized burden of “pulling the plug” seems unkind if not heart-breaking. Why not take ownership of the hard decisions, now, before the crisis stage. Let’s prayerfully, thoughtfully consider the options that may come up before they do. How we choose to proceed will impact our loved ones mightily. One of the purposes of Heritage of Hope is to prompt each of us to think ahead and consider our choices, now, while we are of sound mind and our loved ones are not distraught with grief.
WHO DECIDES–YOUR MEDICAL REPRESENTATIVE?
There may come a time, however, when you are unable to speak for yourself and crucial decisions need to be made. Preparing for such a time is the purpose of an Advance Directive, or a Medical Power of Attorney, or the Five Wishes form. All are valid legal forms, but the Five Wishes www.FiveWishes.org is more extensive. In addition to (1) naming your Medical Representative and (2) stipulating your preferred end-of-life care, Five Wishes also gives you an opportunity to specify (3) how comfortable you want to be, (4) how you want people to treat you, and (5) what you want your loved ones to know.
Wish #1: Only one person can be your Medical Representative. Equip them for this role by discussing your preferences for end-of-life care while you are able to do so. It is suggested that you discuss each of the options available under Wish #2 in some detail.
Wish #2: This critical section gives you an opportunity to study the definitions of “life support” and make it clear (to your Medical Representative as well as your family) what you do or do not want and under what conditions. Most think of life support as a ventilator keeping someone breathing who is really no longer present . . . pointlessly prolonging the point of death. With that image in mind, many conclude they do not wish to receive such treatment. However, the Five Wishes form states:
LIFE SUPPORT support treatment includes: medical devices put in me to help me breathe; food and water supplied by medical device (tube feeding); CPR; major surgery, blood transfusions; dialysis, antibiotics, and anything else meant to keep me alive.
These choices also impact whether or not you qualify for Hospice care. If you have been told that your body is winding down, that you will probably breathe your last within six months, then it could make sense to forgo such life support and embrace the benefits of Hospice for you and your family. If you are not dying, the same procedures described above as life support have been used to save people whose lives were meaningful afterward.
WHO DECIDES—A FORM?
At the beginning of our HOUSEHOLD video, Scott Stuart describes the medical dilemma of his father following a stroke. One doctor suggested a feeding tube to allow Mr. Stuart time to re-learn swallowing. Another doctor wished to disallow this based on Mr. Stuart’s Advance Directive in which he had chosen not to have “life support.” The family prevailed. Mr. Stuart received a feeding tube, learned to swallow again, and lived another two years during which he became a Christian.
What can we learn from this? The same medical professionals that are so good at saving lives are legally bound by the documents we sign. Medical terms such as life support can be confusing. Learn from the Stuart’s family experience. Discuss each of these options thoroughly with your Medical Representative, but leave this portion of the form blank. This necessitates a conversation between your representative and your doctor. A real person—aware of your chances for recovery, not a form, will make these important decisions when you cannot.
Wish #3: Being comfortable is about pain management. It is wonderful to be relieved of pain, but drowsiness is often the result. Family members may disagree vehemently on this important issue, so stating your own preference clearly will keep such disagreements from gaining any traction. It is unmanaged pain that is associated with voluntary euthanasia or assisted suicide. Hospice nurses will tell you staying ahead of the pain is crucial to managing it well. Your third wish will carry the decisive weight.
Wish #4: The biblical command to honor your parents is quite difficult to follow if you have no idea what they want or need. My own mother specified that when it was her time to go to the Father, she would like someone to hold her hand. Because she shared her fourth wish with us, we could honor her. We were powerless in so many ways, but Mom’s simple request focused our energies and generated team work. Knowing this was her desire, one of us was there, around the clock for ten days—holding her hand and loving her. She empowered us to honor her. How might you empower your family?
Wish #5: Much of this content (final arrangements, planning your memorial service, blessing your family) is covered in the HOPE section of the Heritage of Hope series.
According to a multitude of Bible verses, God is numbering my days and yours. What a relief. How much health I enjoy during those days, however, has much to do with my choices regarding food intake, exercise, and rest. How I take care of myself now impacts my options later. Accordingly, my prayer is to receive the blessing Moses gave to the tribe of Asher—strength to match my days. Jesus said we have not because we ask not, so I have begun asking. Please join me in praying for and pursuing strength so we can serve and honor God all the days he gives us. May the fourth quarters of our lives be very fruitful!!
Job 12:10 For the life of every living thing is in His hand, and the breath of every human being.
Acts 17:25 He himself gives life and breath to everything, and He satisfies every need.
Psalm 39.4/90:12 Teach us to number our days, that we may gain a heart of wisdom.
Deuteronomy 33:24-25 MSG Asher, best blessed of the sons! May he be the favorite of his brothers, his feet massaged in oil. Safe behind iron-clad doors and gates, your strength like iron as long as you live.