Will Your Advance Care Directive Harm You?

A recent article from Reuters, based upon doctors writing in the JAMA Internal Medicine, suggests that patients need to be better informed about the implications of their Advance Care Directive before putting that document into effect. Advance Care Directives allow patients to choose which treatments they do and do not wish to receive in the event their health is compromised to the extent that they are unable to state their wishes themselves.

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The article focuses on how selective treatment choices can, in effect, be antithetical to the purpose of Advance Care Directives, which is to balance life-saving measures with the reduction of suffering. For example, it’s possible for an individual to opt for a “partial DNR” (Do Not Resuscitate) by requesting chest compressions and breathing assistance, but not intubation (the insertion of a tube into the trachea to assist in ventilation.) The article cites the case of a 77-year-old man with advanced cancer who opted for this. When he died, doctors were able to restart his heart, but were legally prohibited from intubating him. As a result, he suffered brain damage that left him comatose until his death two weeks later.

To educate yourself about Advance Care Directives, check out Seven Ponds’ Before Death planning guide, and talk to your doctor to make sure your choices are in line with what you actually desire.