A family member or friend is drawing up a living will and asks you to be their substitute decision maker. If you watch TV medical dramas you may have only a partial picture of the decisions you could face should your loved one become unable to direct his or her medical care. Living wills often stipulate that a person doesn’t want “extraordinary” measures taken to sustain life if there is no chance of recovery.
You may have thought about having to say, “Don’t charge the paddles,” in the event your father’s heart stops for the fifth time, or mulled over whether you could agree to turn off life-sustaining machines if MRI scans reveal there is no hope of recovery from a profound brain trauma.
But when it comes to end-of-life medical care, treatments most of us think of as ordinary can be deemed extraordinary. Blood transfusions. Dialysis. Intravenous fluids for people who can no longer swallow.
Instead of, “Should we resuscitate?” you may face the question, “Should we give her antibiotics for this urinary tract infection?” Questions like these will elicit different answers in different households. And in some, the discussion will be heated.
But experts in end-of-life care say these scenarios should be explored early with substitute decision makers — and the broader circles of family and friends.