Step 3:
Talk with your doctor about your directives
When Irish wit John Philpot Curran (d.1817)
was told by his physician that he was
"coughing with more difficulty," he replied:
"That is surprising, since I have been practicing all night."
Quoted in Jones, Clarence,
The Complete Book of Death and Dying.
New York: Harper Collins. 1997
Here is the ideal scenario:
You have reviewed the form and the instructions with your agents and with other family
and friends whose views and concerns are important to you. You have lightly penciled in
your selections on the form and made a list of questions you have for your physician. You
schedule a visit with your physician, at a time your agents also can be present, to
discuss your directives.
At your meeting, your physician expresses great pleasure in having the opportunity to
review your advance care plans with you and your agents. Your questions are answered and
she notes in your record to bring up the subject during your annual physical examination.
She reminds you to let her office know of any changes you make in your directives. You
leave the meeting prepared to complete your document.
This scenario may be more possible to realize than many people might believe.
Physicians do not like to be in the situation of making decisions during a medical crisis
for a patient whose wishes are poorly understood or are the subject of family
disagreements.
Physicians are busy, but they want to hear from you. If your physician does not, then
you need to think seriously about changing physicians.
Communication with your physician about your directives well before they need to be
relied upon may bear heavily on your chances of experiencing a peaceful death. With
advanced age or the onset of serious medical conditions the practical importance and
salience of this communication grows.
Offer your physician the opportunity to discuss your document before you complete it.
Your physician is apt to respond more positively if she believes you want her input.
She should know that you have devoted considerable thought to preparing your
document. Ask for her assurance that she will do all that she can to abide by your wishes.
Approach your physician seeking cooperation. You are there to help your physician
should she have to help your agent carry out your wishes (or implement your living will if
you have no agent) at a time when you are unable to make your own health care decisions.
Do not take a posture of "Honor my directives or else my agent will see you in court!"
Advise your physician of anything about your family relationships that could become a
problem in a medical crisis involving yourself. Tell your physician about any family
members that you definitely do not want to be involved in making decisions about your
health care.
If you believe that your physician might not be supportive at a time when it became
necessary to rely on your documents, your are faced with a serious decision. Do you want
to remain as this physician’s patient? If you do (and there can be very good reasons
for doing this), be sure to discuss your concerns with your agent.
It is essential that you personally tell your physician that you fully trust your agent, preferably in the presence of your agent.
Next...
Step 4: Prepare Your Document
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