Mary-Jane McGinty – April 2020
I heard a physician on CBC talking about Personal Directives in the context of Covid 19. This doctor explained that the pandemic has left physicians making decisions they never dreamed they would make. They are used to doing everything they can to save a patient and now sometimes must decide who would benefit most from treatment
The conversation quickly turned to ventilators, described as the last line of defense in the coronavirus. I assumed that for any patient requiring a ventilator, there was no choice, but I was wrong. The doctor being interviewed described opting for a ventilator as no small choice. He described intubation as an invasive procedure that is very difficult for the patient. Many patients die and among those who survive, there may be lifelong challenges. It is not a decision to be made on the fly. And by the time the decision must be made, the patient may not be capable of making it.
Where the patient is unable to express a preference, the doctor must turn to the next of kin, whom, according to this doctor, are usually like deer in the headlights, never having had the conversation with their parent/spouse etc. So someone has to make a literally life and death decision on the fly, not knowing what the patient would want.
End of life arrangements are not an easy topic of conversation for most people. But as practitioners we learn to approach the subject of wills and personal directives in a direct and clinical manner. We can help you craft instructions for your caregivers that reflect who you are, what you believe, and what you consider an acceptable outcome of your medical treatment.
After listening to this physician’s comments, I phoned a retired physician who knows me well. She was very clear on what she would choose for herself, and why, and helped me decide what my choice would be. I have communicated that to my next of kin and reduced it to writing on case they cannot be found. I feel pretty certain that it will be helpful to my family and to a treating physician who is faced with choice of treatment.
We all want to help and this is just one small thing we can do. We can each make our wishes regarding medical treatment as clear as possible given the wide variety of circumstances that may present. In so doing, we can spare the harried physicians the additional burden of having to take a guess at what you want and/or to elicit instructions from an uninformed and distressed relative. For more information or to have your own Personal Directive drafted, please contact MDW Law at 902.422.5881 or email info@mdwlaw.ca.