Having Your Say: Advanced Directives

In today’s episode, we discuss advanced directives and how they support patients at the end stages of life. We describe the historical context of advanced directives and explain how doctors solely made end-of-life decisions until the recognition of patients’ rights in the 70’s. We outline the consequences of not having an advance directive. We also emphasize the need to proactively plan for advanced directives and underscore how parents and caregivers can encourage younger adults to create advanced directives.

All end-of-life decisions used to be made exclusively by doctors without any input from their patients. Futile, painful treatments were conducted on patients, even if they didn’t want them. In 1969, human rights lawyer Louis Kuttner argued that patients had the right to clearly state their end-of-life care preferences and demand physicians follow them. This right was recognized by the courts in 1975 after the parents of Karen Ann Quinlan—who suffered brain death—sued on her behalf to have her ventilator discontinued. Today, our right to choose our own treatment at the end of life is clearly established—but it only happens if we define our wishes with advanced directives.

“An advanced directive is a set of instructions about how a person wants to be cared for at the end of life.
It’s intended to represent you and your wishes if you become too ill to speak for yourself.”
– Dr. Mitch Winkler.

This week on Cancer Covered:

  • The historical context of end-of-life decisions
  • Advanced directives: their importance and components
  • The need for advanced directives for all adults
  • The types of advanced directives
  • Simplifying and updating advanced directives
  • The “Five Wishes” document and how to obtain an advance directive
  • The barriers to completing advanced directives
  • The completion rates of advanced directives
  • The downside of not having advanced directives
  • How parents or caregivers can encourage young adults to create advanced directives
  • The ideal time to create advanced directives
  • Advanced directive completion in La Crosse, Wisconsin

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