Paula concludes that one major reason we avoid implementing an Advance Directive is that we misunderstand it's intent. Many people may associate the document with "pulling the plug" when, in fact, the document allows you to state your wishes - whatever they may be. If you want full medical interventions in the event of an accident or illness, you can state that in the document as well. It's not only for people who have decided against aggressive medical treatments.
Another misconception is that Advance Directives are only for the elderly or very ill. This is also very untrue. I am in my 30's, very healthy, and I have already implemented one for myself. I've also talked with my assigned Durable Power of Attorney (DPOA) and my assigned alternate DPOA about different medical scenarios and how I would want to be treated in each one. In an eye opening discussion with my DPOA (who happens to be my husband) I asked what he would do if I had a terrible case of pneumonia and needed to be intubated (a tube inserted into my trachea to help me breath). He immediately replied, "I'd pull the plug, just like you wanted." We laugh about it now, but it shows the importance of discussing several scenarios and how each one applies to your Advance Directive. (For the record, if I am in a persistent vegetative state and doctors want to intubate me, forget it; for severe pneumonia, which carries the possibility of a full cure, please do.)
Do you have your Advance Directive in place?
Make Your Wishes Known with Advance Directives
Angela – Great post, thank you. Misunderstanding the intent of advanced directives is a key theme that seems to represent other initiatives like palliative care or end of life care. And the other misconception that these services are only for the ill or elderly is also problematic as you mention. These are services that all should be encouraged to access and willingly seek out despite living in a society that is designed to prolong life. There is plenty of research to support how these services including the simplicity of the 5 wishes save significant costs and bring signifiant care and comfort. It might be even more effective, too, for even those who have a better prognosis to take an active role in these services or philosophies of care that differ from what’s often the norm. Also, seems like advanced directives and palliative care hold the most important potential for creating new “scripts” for communication that would help re-determine the American way of dealing with illness and impending death. Barriers certainly remain, however, that preclude our ability to discuss illness and death explicitly. And furthermore, the attempt to control death has resulted in a loss of understanding of the meanings surrounding death. But, I think as your blog eloquently states repeatedly, these “advanced” services are ultimately refashioning what it means to live a human life because for one, it gets people – patients, families, and medical providers – talking in different ways about very important things. And clearly, how we speak says a good deal about who are we, the attitudes we hold and the behaviors we use to guide our actions and yield the outcomes we want…