Winnipeg Free Press - PRINT EDITION

Living will lets you die the way you want to

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A skeptical patient recently asked "Why should I have a living will?" I replied, "Because no one in this world will care as much about how you die as you will."

So don't say "no" to a living will because of unfounded myths, such as the following.

-- "If I sign a living will, it allows doctors to pull the plug and end my life!" In fact, the very opposite is true. North American doctors today spend much of their time worrying about lawyers when treating all medical dilemmas. But when faced with the decision of whether or not to terminate a life, they avoid it like the plague. They worry any move to end a life may result in legal action by the family, nurses or other physicians who believe life must be prolonged to the last breath. So without a living will, they run for the woods and leave your fate to nature. I have no problem with that decision if it's your considered wish.

-- "Signing a living will is a waste of time because it's not a binding legal document." There is an element of truth in this. But that does not mean it's a worthless document. Rather, consider a living will an advance directive that informs family members what you want done if you're unable to speak for yourself.

There are few guarantees in life, but it's the best insurance policy I know of that gives you a fighting chance of dying the way you want to die.

-- Don't believe the death notices that often say, "John Smith passed away peacefully." Only if you have the luck of the Irish does this happen. It's been my experience during a long career in medicine that in the real world there is no such thing as death with dignity. If you are felled by a massive heart attack, death comes quickly but there's no dignity in gasping for air.

In the majority of cases, death is a slow process that is never described in the obituary column. I've never believed that having to use a bedpan, a catheter to empty the bladder or wearing a hospital gown with no backside was anything but undignified. Sorry, but few are peaceful Hollywood deaths.

-- "Living wills can't cover all the things that might happen while dying so why bother to have one?" But you don't need a 200-page document to get the relevant message across. As Albert Einstein remarked, "It should be simple, but not too simple." It's easy to get a straightforward message across in a very few words if you use the right words.

-- "My family knows what I want done if I become seriously ill, so I don't need a living will." You may be right, but your family doesn't own doctors or the hospital and they don't write the law. So if you're comatose, how do doctors or hospital administrators know what you want done? After all, as far as caregivers are concerned, they may think family members are more interested in your bank account than in your life on this planet.

Without this vital document you may pay the price for such folly. It means intravenous feeding and other tubes will continue unless you're lucky enough to have a guardian angel on your side. And don't put your faith in hospital ethics committees. They can and do make good decisions, but I would not sleep well unless I'd chosen my own committee that included a veterinarian.

-- "You make some good points. I'll talk about this one of these days with my lawyer." Usually "one of these days" really means none of these days. It's a major error people make and often suffer needlessly due to procrastination. And also remember there's no point in a living will unless someone knows where it is.

Republished from the Winnipeg Free Press print edition August 9, 2013 A17

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