End-Of-Life Decisions: Who’s in the Driver’s Seat?

https://readthespirit.com/ourvalues/wp-content/uploads/sites/17/2013/03/wpid-Young_and_old_hands_clasped.jpg“Nothing can be said to be certain, except death and taxes,” wrote Benjamin Franklin in a letter dated November 13, 1789. Ben wasn’t thinking of end-of-life decisions when he wrote it. He was making the point that the newly established Constitution “has an appearance that promises permanency”—but it wasn’t certain, unlike taxes and death.

It seems fitting, then, that the everlasting twins should have their name days one after the other: National Healthcare Decisions Day (NHDD) was last Friday, one day after Tax Day. NHDD is an “initiative to encourage patients to express their wishes regarding healthcare and for providers and facilities to respect those wishes, whatever they may be,” according to the NHDD website.

On Tax Day, Obama issued a presidential memorandum reinforcing healthcare decisions, such as decisions about when and how a patient should be kept alive or allowed to die. The memo pertains to both the rights of hospital patients to receive whomever they want as visitors and to designate “surrogate decision makers for medical emergencies.” If hospitals participate in Medicare or Medicaid, then they have to see that “all patients’ advance directives, such as durable powers of attorney and health care proxies, are respected, and that patients’ representatives otherwise have the right to make informed decisions regarding patients’ care.”

The White House memo was issued in light of an increasing trend for hospitals and healthcare providers to ignore or broadly interpret end-of-life directives. As we’ll see this week, some states allow healthcare workers to decide whether or not to participate in fulfilling end-of-life decisions.

What’s your opinion about end-of-life decisions? Who should be in the driver’s seat if a patient is unable to communicate? Did Obama do the right thing by reiterating the rights of patients concerning their rights to determine how and when they will die?

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