Advance care planning and medical issues to consider

January 12, 2011

Technology is both a blessing and a curse.  It can bring someone back from the brink of death so that they continue to live a fulfilling existence.  It can also keep one alive for years even if there is no brain function.  Clearly one needs to be extremely specific as to their wishes for future medical care.  To make informed decisions, it’s necessary to understand the underlying medical conditions to which advance planning documents allude, such as:

  • Whether your medical condition is reversible or not.
  • If the treatment will help you live longer, and if so, will it improve your quality of life?
  • If you have a terminal medical condition that is progressing to end-stage.
  • If you are in a persistent vegetative state or a prolonged coma.
  • When CPR may not be helpful.
  • How “chemical codes” are relevant to your medical condition.

Documents included in advance care planning include living wills, medical directives, proxy designations and a values history. These documents establish your wishes for treatment should you be unable to communicate your wishes at the time of critical illness. This system also enables your family and friends to implement your decisions with peace of mind.

“Do Not Resuscitate” orders (DNRs) must be drafted and explained very carefully. State regulations governing application of DNRs vary widely.  For California, information can be found here. How a DNR is interpreted also depends upon whether the individual is hospitalized or not.

Please read the detailed information at the American Hospice Foundation’s “Medical Issues to Be Considered in Advance Care Planning” and then comment below.

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