Last night we watched the PBS special on “facing death” which documents the agonizing stages of treatment and decision-making towards death of several patients, their families, and medical caregivers at New York’s Mt. Sinai Hospital. I was struck by how difficult it was for all of them to accept death; even health care proxies — people who had the patients’ legal permission to decide on their behalf — agonized and delayed when it came to say “no more.” It’s safe to say that most of us are unprepared to face the inevitable. It’s high time we talk to each other about the kind of end-of-life care we want for ourselves.
The three of us came to talk because my guests had recently signed a Health Care Representation Agreement. Governed by provincial laws, these dear friends have agreed to help make decisions about my personal care, refuse specific types of medical care, including life support care or treatment, and assist in placing me in a care facility. My friends, both nurses, one a senior practitioner in palliative care and the other just beginning her career, are now under a statutory duty to comply with the wishes and instructions I express while capable. As one of them said last night, “you know what this means — we have remain friends from now on.” I’m deeply thankful that they have taken on this duty and place my trust into their hands and hearts. As it says in a central paragraph of the Agreement:
If the times comes that I can no longer take part in decisions for my own future, and there is no reasonable expectation of recovery from physical and mental disability, I request that I be allowed to die and not be kept alive by artificial means or heroic measures. Death is as much a reality as birth, growth, maturity, and old age — it is the one certainty. I do not fear death as much as the indignity of deterioration, dependence, and hopeless pain, and I ask that medication be mercifully administered to me for terminal suffering even if it hastens death.
Who will speak for you … if [when] the time comes? Please write if you think I might be able to assist you.