Advance directives are a bad idea

By Judie Brown

End-of-life care is a crucial component to healthcare and one that has received much attention lately. With the push for people to sign advance directives, and many not knowing the implications of their signature, education is key.

Depending on how you look at it, planning on how you wish to be cared for at the end stages of your life can be nothing more than playing a game of Russian roulette. The only difference is that the person holding the gun to your head is not you!

Recent headlines draw me to make that conclusion, so allow us to examine the reasons why this is so.

First, let us define advance directive:

It's a document intended to instruct medical personnel on the kind of healthcare you would like to receive should you become unable to communicate your wishes. Common examples are a "living will" or a type of document called a "durable power of attorney for healthcare." This latter document gives the power to make decisions about your healthcare to another person of your choosing. Every state now has laws authorizing one or more forms of advance directives.

This may have sounded good in the old days, but no more! Since 1991, we have had a federal law, the Patient Self Determination Act, in place. The PSDA "requires that whenever any adult is admitted to a hospital for any reason, he or she must be informed about 'living wills' or other types of 'advance directives' available by law."

In today's culture that places an increasing emphasis on deciding when and how a patient should die, signing such a document can mean surrendering your fate into the wrong hands. Sound preposterous? Think about this: There is a bill before Congress right now that would pay senior citizens $75 if they create and sign an advance directive! Senator Tom Coburn, M.D., introduced this proposal, known as the Medical Choices Empowerment and Protection Act. His timing was bad, to say the least. At a time when the government is already involved in far too many aspects of daily life in which it does not belong, Americans do not need or want such over-reaching, particularly when dealing with how death occurs.

Even if there is a $75 bonus-the proverbial carrot on the stick-the end result could be anything but a bonus!

And get this! There is a website already in existence called "My Directives" assuring the visitor that since somebody is going to make decisions about the end of your life, why not let it be you? Trouble is, there are far too many instances in which an unsuspecting patient has signed such a document only to be rendered unable to remind his caregivers that he really does not want to die earlier than God's appointed time.

And now that your advance directive is possibly going to go viral with all your other medical records, who is to say exactly what will be found or how it will be interpreted when you can no longer speak for yourself?

Lastly, a new study indicates that those who have signed advance directives (living wills) and have been diagnosed with advanced dementia, will not receive the "aggressive care" that might otherwise have been given to them in a nursing home setting.

While cost savings are cited, we do not know at what human cost this money is being saved.

What do the authors mean by "aggressive care"? Nutrition and hydration to prevent the possibility of starvation? Ventilator assistance so that the patient can breathe comfortably? Who is defining the terms and why? Valid questions like these raise another red flag, warning us not to rush into signing an advance directive.

Protect yourself and your loved ones. Be on the safe side. Learn about American Life League's loving will, a truly pro-life alternative to the living will.

© Judie Brown