With more than 30 years as an attorney under my belt, I can tell you that most of my clients have some fairly strong thoughts on end of life care and treatment, usually based on their faith or study, personality or pluck. Sometimes these thoughts are well considered and reasoned, other times they seem slightly like a “knee jerk” reaction such as: “I don’t want to endure the same thing so-and-so did last year.”
Studies have shown us that doctors in the USA often “die differently” than those not in the medical profession. One study, nearly 30 years old, and others that have followed, indicate that systemic pressures in our health care delivery programs mean many doctors would suggest aggressive care for quite sick patients even though those same doctors might eschew the suggested treatment were they the patient with the same condition.
For those on Medicare (many elderly and some on disability) a suggestion had been kicking around for some time–counseling. In other words, allow doctors to be paid a little something to discuss end-of-life charge for those patients who seek out this information voluntarily. And, one hopes, before a medical crisis hits.
There was a bit of recent coverage on this idea in a recent NPR story: http://www.npr.org/sections/thetwo-way/2015/07/08/421279312/medicare-to-pay-for-voluntary-end-of-life-counseling
Discussions like this can be helpful for individuals and those loved ones who are part of their life. In this instance, like most, knowledge is power.
Remember too, in Michigan, that adults speak for themselves in regards to medical treatment and care (or in saying “no” to medical treatment or care). Should two physicians though, think we can no longer communicate our medical wishes and desires, then, and only then, can doctors and facilities turn to others. Who would those “others” be? A person we have named as patient advocate via the Michigan law, or a guardian appointed by the court.
Getting a patient advocate document in place (sometimes also called a medical power of attorney) makes good sense–and it makes sense for even younger adults. Remember, some of the most heart-breaking cases in the country surrounded care for younger or middle aged people.
Terri Schiavo case 1990-2005 (approx. age 27-41)
Karen Ann Quinlan 1975-1985 (approx. age 21-31)
In re Martin, 450 Mich. 204, 538 N.W.2d 399 (1995) (approx. Age 41-48)
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