THE VIRGINIAN-PILOT
Copyright (c) 1996, Landmark Communications, Inc.
DATE: Sunday, June 23, 1996 TAG: 9606190031
SECTION: REAL LIFE PAGE: K1 EDITION: FINAL
SOURCE: ALEXANDRIA BERGER
LENGTH: 75 lines
YOU ARRIVE in the emergency room, severely sick or injured. A patient advocate asks if you have a Living Will.
You say, ```No.''
The advocate then inquires: ``Do you want to be revived, should it be determined your condition is terminal? Do you want us to hook you up to machines and keep you alive? Do you want us to prolong your life, even though you may be suffering?''
A piece of paper is thrust into your hand. You sign immediately.
You live.
Would you remember what was written on the document you signed?
If you answered, ``yes,'' give this column to a friend. If you answered, ``no,'' read this and then see an attorney, because, to date, our chances of living forever are limited.
Yet, you would never know this, judging from the current debates on the right to die, physician-assisted suicide, and nurses performing euthanasia.
For centuries, death represented a continued evolution, encompassing appropriate good-byes - family, physician and patient, together.
Americans, among other cultures, have created a new belief system, promising technology will provide quality of life and prolong the ``dreaded'' process of dying, indefinitely. We've come to fear death as a plague.
A round of debates has ensued. Do we administer life-saving drugs? Do we overtreat, undertreat, not treat? Do we unplug the machines, pull out the tubes? What is ``quality of life''? When does the patient become terminal?
The juries and circuit courts that have ruled in favor of Dr. Jack Kevorkian and assisted suicide for competent terminally ill patients understand the dilemma technology places before us.
So no one should be shocked at the number of nurses who have performed assisted suicide or euthanasia. It is a significant symptom. These professional caregivers have been overexposed to the technological process of dying, as if dying itself were not the natural termination of earthly life; but an interim trip to the next life-sustaining machine.
Dr. Terence Davies, chairman of the department of family and community medicine at Eastern Virginia Medical School, emphasizes, ``For many, being in severe pain is justification to terminate one's life. It is up to the physician to provide relief for both physical and emotional pain.
``We have to stop acting as physician heroes, trading logic for technology, and emphasize caring. An aging society, longer lives for those with chronic illness are at the heart of these issues.''
There is a partial solution. Create a Living Will.
Should you be diagnosed with a terminal condition, from which there can be no recovery (where death is ``imminent''), no artificial means to prolong your life will be used. You will be permitted to die naturally. You will be administered medication only to alleviate pain.
Your physician and family must honor your legal rights to refuse treatment. There is a catch: A Living Will does not define terminal illness. It uses the word ``imminent,'' which means ``at hand.'' It does not cover Alzheimer's disease, end-stage MS or severe strokes.
Standard Living Wills can be expanded by an attorney to encompass your specific wishes. However, the legislated language of Living Wills has been misinterpreted by physicians fearing lawsuits.
There is an option:
Create an Advance Medical Directive. It is more specific, customized and exacting, making guesswork less possible. With it, include:
A Durable Medical Power of Attorney: It entrusts an individual you choose to make decisions for you regarding life-prolonging measures, in situations not anticipated in your Living Will, Advance Medical Directive, or lack thereof.
``These documents should be reviewed periodically,'' says Melvin J. Radin, a Norfolk lawyer. ``People change their thinking, and advances in medicine continually redefine illness.''
J. Samuel Glasscock, of Glasscock, Gardy and Savage, attorneys in Suffolk, put it aptly: ``Physicians are trained to keep people alive. These documents remove the pressure from physician and family, preventing them from making the wrong decision.
``The person is saying, `This is my decision . . . what I really want.' ''
Don't wait for a patient advocate to say, ``Sign here.'' by CNB