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Editorial: Making end-of-life decisions in advance reduces uncertainty

Nov. 01, 2012 @ 12:00 AM

People who want a say in their own medical care even if they are incapacitated have a new tool at their disposal starting this week.

The West Virginia Center for End-of-Life Care is launching a statewide registry for advanced directives. The registry will allow a person to place documents spelling out his or her end-of-life wishes into a statewide database that can be accessed by health-care providers anywhere in the state. That means even if someone is away from his or her own doctor when unable to make decisions about medical treatment, his or her wishes can be looked up and known by whoever happens to be providing the care.

This is a good, added step for those who have taken the time to figure out their end-of-life wishes and completed the appropriate documents, as many West Virginians have done. In fact, about half of adult West Virginians have completed at least one advance directive, such as a living will or medical power of attorney. That proportion is significantly higher than any other state, according to Dr. Alvin Moss, director of the Center for End-of-Life Care, an agency established by state law 10 years ago to provide resources related to end-of-life planning.

Those who have not completed advance directives may want to strongly consider doing so. They not only specify your wishes for end-of-life care, but they also serve as a road map for family members who otherwise may be confused about what to do if someone becomes seriously ill or injured and unable to communicate their wishes at the time of the life-threatening event.

Advanced directives come in several forms. A living will allows an individual to state whether life-prolonging medical intervention is wanted under circumstances of a terminal disease or a withdrawn, vegetative state. A medical power of attorney allows a person to designate someone else to make medical decisions when he or she is rendered unable to make one. A patient and his or her physician also may want to consider a "Do Not Resuscitate" card that indicates no cardiopulmonary resuscitation should be given when the heart stops. And a POST form (Physician Orders for Scope of Treatment) converts a person's wishes into medical orders that are to be honored in all health care settings.

For many people who have taken the time to complete advanced directives, the prospect of lengthy suffering near the end of life is a key consideration. In a 2010 survey conducted by the Center for End-of-Life Care, about three-quarters of the respondents said they would rather live a shorter time to avoid suffering and life-prolonging machines. That's one consideration. Other factors are eliminating the uncertainty for family members and avoiding expensive life-prolonging treatment when there is no hope that the individual will recover.

To learn more about the new electronic registry and advanced directives, go to the website http://wvendoflife.org. Thinking ahead about your end-of-life options could bring peace to you and your loved ones both now and later.



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