Who decides?


Who decides what the best treatment is for our loved one; a healthcare proxy, the family, the doctor? If it is the doctor, which one? The pulmonologist, the surgeon, the heart specialist? Is the doctor willing to do what the family decides?

End of life questions are scary for the patient and the loved ones. We usually think these decisions are premature. “Let’s wait and see.” But how long do we wait and “what if they recover tomorrow?”

She lay there tubified and attached to machines that kept her alive. The combination of heart disease, lupus and emphysema had finally caught up with her. She had said that after one week she wanted to be disconnected. There was no healthcare proxy, only her whispered wish as she was rushed to the hospital. She floated in and out of consciousness. The family gathered around. The seventh day came and there was a decision to be made. “What, exactly, does one week mean?” They decided to wait three more days. At that point, they knew the deed had to happen. Were they all in agreement?  They told the doctor, but he said he would have to call another M.D. because he did not believe in ending a life. He believed she should stay connected to the machine that kept her breathing. When there was pain, in went the morphine. There were tears all around at the sight of her struggling. Is there anything more painful than watching a loved one at the end of his or her life?

So, the substitute doctor was called. He disconnected all attachments from her body. She actually lived and was conscious for one more day. Everyone held their breath and hoped. She had a chance to say good-by. She let out a sigh of relief and passed away peacefully with her loved ones around her.

No one should experience the indecision, the back and forth that this family went through.

It’s better to have that talk early, painful as it may be. That way no one will have to decide and then feel guilty for the rest of their lives. Even better, have your loved one write it down so there will be no questions.


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