DEBORAH, HER MOM, AND DOING THE RIGHT THING



DEBORAH, HER MOM, AND DOING THE RIGHT THING








By Judie Brown
President of American Life League
Member of HALO’s Board of Advisors
A pro-life friend named Deborah wrote to me, saying:
My mom has stage 4 cancer, so I took one of the American Life League Loving Wills I got several years ago and read her the form about food and water and asked if she wanted to sign one so they will have to give her nutrition. She said she wanted to. My daughter is a notary, and she came to the hospital and read over the form. She said it wasn't sufficient because it didn't go into detail about DNR (Do Not Resuscitate) order. She notarized it anyway, but I need your input to make sure this is all we need.
I promised Deborah that I would check into this, and I was grateful to be able to write her back and assure her that the Loving Will is compliant with Texas law. But I was also told to make sure she knew this about current Texas law. The Texas Advance Directive Act violates the personal liberties of conscience among those who do not ascribe to euthanasia practices. How? According to Texas Right to Life, TADA’s 10-Day-Law has “been accurately described by people across the political spectrum as ‘death panels.’” The death panels are hospital-appointed ethics committees that basically rubber-stamp doctors’ decisions to stop patients’ treatment, with or without their consent. After being notified of such a decision, “the patient and his or her legal surrogate have a mere 10 days to arrange an emergency transfer to another facility that would be willing to continue treatment. Such a transfer is often extraordinarily complicated” in so-called ‘futile care’ cases, “and there are no practical means under the 10-Day-Law for a typical patient to stop the ticking clock.”
The attorney I asked for advice also advised us that Deborah and her daughter, who is not an attorney, needed to understand the facts about a DNR. According to experts, stopping life support can be fraught with problems. No matter what kind of form you sign, that piece of paper can be used to terminate your life if the wrong person is interpreting it or if the wrong person has been given control over your care decisions should you become unable to make those decisions yourself.
I also shared the following with Deborah because it is never adequate to provide a simple answer when we are dealing with the challenges someone faces while caring for a loved one and attempting to protect him from those too willing to cut lives short.
Chris Kahlenborn, MD, explains:
Many people, often under the guidance of their lawyer, have living wills which specify what type of medical treatment they wish to have or forego should they have a terminal illness. There are several problems with this. First, the living will is a rather rigid document, often prepared years prior to the occurrence of the patient’s first medical illness, after which circumstances and opinions have often changed. Second, many physicians interpret a living will as a “do not resuscitate (DNR)” order, so that, if you are admitted for a non-terminal illness, you could be categorized as a DNR patient, when that may not be your wish. Third, patients with living wills, in general, will get less aggressive hospital treatment. My advice is to speak with a trusted friend or family member and make them your power of attorney for healthcare decision maker instead of obtaining a living will.
In the process of trying to find adequate help for Deborah so that she can rest assured that her mother is cared for properly, I learned a lot about resources available to Texans. For example, the St. Thomas More Society has specific documents that are fundamentally in-line with Catholic teaching, including an advance directive and a medical power of attorney. In addition, attorney Kassi Marks has a blog entitled Kassiblog that addresses these tough questions and monitors current state law.
Finally, it is always prudent to rely on the words of well-known Catholic doctors who have studied these matters and who know what is at stake from the Catholic ethical perspective. Among the most eloquent is Paul Byrne, MD, who wrote this warning about DNRs in the online booklet “Life, Life Support and Death”:
When it is directed by a dying patient or the patient’ s proxy that a gravely burdensome treatment will not be administered, a specific order for that specific non-treatment must be written. Written orders must be as precise as possible. “Do Not Resuscitate” or “No Code” are examples of ambiguous orders widely accepted by physicians and courts. Do these orders mean no maintenance of an airway, or no ventilation, or no cardiac resuscitation, as well as no new or additional therapy? Furthermore, in light of the weakness of human nature, once the course has been plotted by a DNR (“Do Not Resuscitate”) or a “No Code” order, there is a tendency to preclude, eliminate, or reduce other kinds of “ordinary” treatments, such as visits by physicians and care given by nurses and others. Broad orders of “Do Not Resuscitate” (DNR) or “No Code” must be avoided. At no other time in medicine are treatment-orders that are broad and non-specific considered to be within the standard of care.
As someone who comes to this topic from the pro-life Catholic perspective, I am aware that, when a person we love is very ill, though we might have the best instincts in the world, our emotions can frequently get the best of us. That is why it is a good idea to rely on the wisdom and help of those who are not directly involved with your decision, but who care about the fact that the right decisions must be made.
This is one of the reasons why I am so grateful to God to be part of the Healthcare Advocacy and Leadership Organization. Deborah could rely on me in her time of need, and she trusted that I would provide her with the solid answers she needed to help her daughter understand the matters at hand and to help her look out for her mom’s best interests.
HALO can do that for you.
Note from HALO: Be wary of any healthcare advance directive that is not specifically life-affirming, such as the directives provided by your state, healthcare facility, or doctor’s or attorney’s office. There are several life-affirming options to choose from in addition to American Life League’s Loving Will. HALO offers its Life-Affirming Medical Proxy (LAMP), and endorses the Patients Rights Council’s Protective Medical Decisions Document (PMDD); Pro-Life Wisconsin’s Protective Power of Attorney for Health Care (PPAHC); and, for Canadians, the Euthanasia Prevention Coalitions’ Life Protecting Power of Attorney. These are all medical power of attorney (MPA) documents in which you appoint an agent to make medical decisions for you in the event you cannot make them for yourself. To learn more, visit the main page of our website — www.halorganization.com – and look for the red box, then enter the name of your state or province to learn which document may be right for you.
The American Bar Association advises:
Most states do not require a particular form, but they do have witnessing requirements or other special signing formalities that should be followed.
Even if your state requires a specific form, doctors have a legal obligation to respect your clearly communicated treatment wishes in any manner or form expressed, as long as the wishes are medically appropriate. https://www.americanbar.org/groups/law_aging/publications/bifocal/vol_37/issue_1_october2015/myths_and_facts_advance_directives/
Regardless of which MPA document you choose, there is a catch. What does the term “medically appropriate mean” and who will decide what is “medically appropriate” treatment? Do your best to protect yourself by naming as your medical decision-maker someone who will not be intimidated by healthcare professionals or medical terminology, or by a “futile care” decision; someone who will defend your right to life-sustaining medical treatment and care even if that requires seeking legal help.
Every person 18 years of age or older should have a life-affirming MPA naming someone to make decisions for them and protect them in a medical crisis if they cannot speak for themselves. Your life or the life of a loved one may depend on it.

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