Friday, September 12, 2014
Family Emergency (Extreme Decision Making)
I am hoping that the recent problems generated by my family emergency are sufficiently under control that I can, once again, return to normalcy. I will try to share what I have learned to the best of my abilities. The day may come when you will find it necessary to make life or death decisions for someone you love. You will not have the technical expertise to make these decisions and you can’t expect the physicians or other professionals to give you useful statistical data. A doctor isn’t going to tell you that this course of action will produce this result 90% of the time. Living wills are often out of date or conflict with the stated desires of the author. Still, you must choose to sign or not sign permission documents. I am basically satisfied with the decisions I have made for others over the last few months. I do not seem to be suffering from the “what if?” syndrome. Here is an attempt to deconstruct what I did in moments of crisis. Run. Do not walk to the best experts you can find, always remembering that in a multitude of counselors you will find wisdom. Pump them for as much information as they are willing to share. It is important to learn the best outcome, the worst outcome, and the most probable outcome for a particular course of action. Often one of these three bits of information will make the decision for you. In one of my decisions every professional with the exception of one social worker recommended a particular course of treatment. I went against the majority opinion because the worst outcome of one course of action would be equal to the best outcome of the second. This decision turned out to be excellent because the actual outcome exceeded any reasonable expectation. When facing another decision, the worst outcome was unthinkably horrible. One course of action had little hope of success and a great probability of a ghastly failure. The second course of action had little hope of success but the probable outcome was acceptable, a natural death without suffering. The third course of action (a lack of any action) would result in certain death. I choose the second course of action, leading to the predicted result. I won’t sit here and tell you that my heart was not a part of my decision making process. This is family. It is impossible to make completely rational decisions in such situations. Therefore it is important to provide your loved ones with as much information as possible long before the moment of crisis. Write out a living will. Make certain that the person who will hold medical power of attorney on your behalf not only has a copy of your living will, but an understanding based on open and frank conversations as to what you believe the words the lawyer put on that piece of paper actually mean to you. Openness and honesty are important in all aspects of healthy close personal relationships. Life and death are no different than finances, as we approach the end. Unless you die suddenly, without warning, a day will come when someone else will need to pay your bills and tell the doctor how to proceed. The more tools and information at the disposal of the individual who holds medical power of attorney or durable power of attorney on you behalf, the better she can perform her job. Let me add that I have read that doctors request much less end of life medical care than the general population. What does that tell you?