What kind of end-of-life care do you want? Don’t leave the burden of such decisions on your loved ones. Make a living will, which will speak for you when you are unable to, says lawyer Lyn Boxall.
About two years ago, I answered a phone call from my sister. She lives in my home town, Adelaide in South Australia, and I’ve lived in Singapore for many years. “Mum was found unconscious on the floor of her bathroom this morning and now nothing she’s saying is making any sense,” she said. “The doctors are trying to work out why. They think they may need to do brain surgery and they want to know whether she would want everything possible to be done to resuscitate her if the surgery doesn’t go as expected. Do you know what she’d want? What should I tell the doctor to do?”
Our mother was 85 years old. It was a truly horrible moment. No child, even one old enough to be a grandmother herself, should have to bear such a burden. Our family hadn’t ever discussed such things – too many cultural taboos. And yet my sister and I did have to make a decision if the surgery was to go ahead. Happily, it turned out that Mum didn’t need it – she wasn’t making sense because she was having a particularly bad dementia day. But her dementia also meant that we couldn’t find out her wishes for any future decision either. It was simply too late.
Contrast with my grandmother, who had always said that her wish was to die quietly in her sleep. I grew up with that knowledge, even though for years I was far too young to understand the implications. Around 25 years ago, my grandmother was 94 years old and in a coma because of heart failure. Letting her go as she wished was far from easy. But it was much less burdensome than making a decision without any insight about her view of life and death.
I urge my readers not to burden their children, siblings or other decision-makers in the time of a ‘life or death’ health crisis unnecessarily by not letting them know, well ahead of time, their wishes about treatment. It’s difficult. It’s not a single, serious conversation. It’s something that is so fundamental that it needs to become simply part of who we are, just as it was in my grandmother’s case.
There is a way we can make our wishes clear and formal, a way that can lift the decision-making burden from the shoulders of others, at least about ‘extraordinary life-sustaining treatment’. It involves making a ‘living will’ that clearly puts our wishes on record (though they can be kept private unless and until needed). The official name for a ‘living will’, at least in Singapore, is an ‘advance medical directive’.
In Singapore (and elsewhere) a person can also make a ‘lasting power of attorney’. This means that someone else, such as a close family member, is legally authorised to make decisions for them about their welfare, property or affairs when they no longer have the capacity to do so. It doesn’t include making decisions about life-sustaining treatment, so shouldn’t be confused with a living will.
Those who read this also read:
1. http://www.patientsengage.com/news-and-views/turning-life-support
2. http://www.patientsengage.com/news-and-views/treatment-decision-singapore
