I am a nerd. There, I admitted it. Rather than watching talking heads argue on newschannels or anything on network TV, I regularly check out TED talks on YouTube. Like everyone else, I’ll stop and look at something I find interesting. I watched this video because it is a huge issue for my clients but also as a matter of policy. Recently, it was announced that Medicare is going to start reimbursing medical professionals for discussing end of life decisions with their patients and as I watched this video I could not help but wonder if this video played any part in that discussion.
Two things the speaker said I want to highlight. First, he asked, “In the event you became too sick to speak for yourself, who would you like to speak for you?” His next question was, “Have you spoken to them about the things that are important to you.” Those are two very simple questions but they are important and powerful.
A hospital administrator told me recently that the State needs to set up a campaign to get more people to sign living wills. A living will is a document that makes clear your wishes regarding some specific end of life issues. The administrator said that what they see in the hospital time and time again is that the local caregivers of a dying patient decide not to continue extraordinary measures to artificially prolong the live of the patient. Without failure, however, an out of town family member (who has little contact with the patient and has not been providing any assistance) will demand that the doctors, nurses and staff stop at nothing to “save” the life of the patient. (You have to watch the video linked above to get why I put “scare quotes” around “save”).
What’s lost in that situation is the patient’s voice. If people understand that to not speak is to speak, they will understand that by not letting someone know your wishes and appointing someone you trust to carry them out that you have just given someone a car, told them to drive but did not give them a destination. By not acting, you have said “whatever”.