Eston Williams is a Minister at Aley United Methodist Church. This is the second of a two-part series the Rev. Williams has written. Part one ran in Friday’s Athens Daily Review.
As I was studying end-of-life issues, an important book came into my world written by two sisters.
Dr. Jeanne Fitzgerald is an emergency room physician and her sister, Eileen, is an attorney. They draw on two lifetimes of experience helping families answer these very difficult questions, and have some suggestions that can help us make the best choices at the end of our lives.
Their book, “A Better Way of Dying: How to Make the Best Choices at the End of Life,” introduces a very helpful concept which they call “The Compassion Protocol.”
Their “Contract for Compassionate Care” gives us the opportunity to be much more specific about the way we want to be treated at the end of life.
In addition to the wording in the Directive to Physicians required by Texas law, they encourage us to state clearly our desires, should we have an advanced progressive illness, become permanently unconscious, experience persistent extraordinary pain and/or suffer from dementia.
Based on their ideas, here is the way I have worded my advance directive:
“If I live to an extremely old age, and my body is beyond repair, I do not want to be kept alive. I want to take advantage of the next exit event, whether it be pneumonia, infection, heart attack or cessation of breathing. Do not resuscitate me, and do not take me to the hospital, or give me any medicine which would keep me here. Please keep me comfortable and conscious with pain-reducing medications.
“If for any reason I am unable to tell you what I want, assume that on the inside I am screaming at you, ‘Please let me die!’
“If I suffer from any of the following conditions, please cease all curative care, and provide only comfort care:
• I can no longer recognize or interact with my family and friends.
• I can no longer respond to commands or requests.
• I am in severe and untreatable pain.
• I can no longer feed myself.
• I have to be on kidney dialysis.
• I must use a breathing machine or feeding tube.
• I cannot take care of myself, and need someone to care for me 24/7.
• I can no longer control my bowels.
“If I begin the long, slow decline into dementia, due to Alzheimer’s, let me take advantage of any possible exit event, and die a natural death, without a trip to the hospital for pneumonia or other curable illness. Even fairly early in Alzheimer’s, while I am still able to carry on coherent conversations at times, and still recognize family members most of the time, I do not want to live when my mind no longer works.
“Do not rob me of an exit event early in dementia that could save me from a year or two (or five or 10) in a nursing home, or at home when I would be a burden to my family.
“Should I start to refuse food and water, naturally as the disease progresses, stop asking to eat or drink, and stop reminding me to do so. Please place food and water by my bedside three times daily, but without interference, and let me decide whether to eat or drink.”
Now let me emphasize that I am not encouraging you to make the same decisions that I have made. What I am encouraging you to do is to do your homework and make these very difficult choices yourself.
Consult with your doctor and with those who love you. Do the paperwork required. Choose and designate a healthcare decision-maker, and give them a medical power-of-attorney, so that they can insure that your desires are followed.
Please don’t force your family to make these decisions for you. Give them the last gift you will ever be able to give them, the gift of knowing what you want.
Leave them knowing that you love them so much that you wanted to relieve them of the burden of making those decisions for you.