Vulnerable at the end of life

I was chatting semi-aimlessly with a lawyer friend the other day when the issue of medical powers of attorney and medical advance directives came up.

My friend, often one to blurt out profundities without realising it, said that he objects to patients being asked about whether or not they would want to be resuscitated should something go wrong at the time of being admitted to hospital for surgery. He argued that an imminent surgery and the understandable patient anxiety prior to the operation would make anyone vulnerable to making a poor decision or to being led to a decision that they might not otherwise make.

I’d never thought of it that way and I’m not entirely convinced.

After all, other than in an emergency, patients hopefully would have had some time to consider their options in consultation with their family doctor and specialist. It should be the case, with good quality care and planning, that the options would have been discussed and decisions made prior to the patient attending the hospital. Nevertheless, it seems to both of us that a good protocol for such decision-making would be that all of these details should be finalized prior to hospitalization.

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