It’s time to have end-of-life conversations with a doctor, not just your family members.
Consider the nightmare scenario you’ve heard many times by now: Twelve patients with COVID-19 arrive in the ICU needing emergency mechanical ventilation. Only six ventilators are available. Which patients should the doctors place on ventilators? Which patients should be left to die?
An advance directive is a document that details a patient’s wishes in the event that he or she becomes critically ill. They can vary quite a bit, but a standard advance directive always addresses the question of whether or not the person desires life support—i.e. medicines and machines to keep the person alive when organ systems are failing.
A) Mechanical ventilation and intensive care , with the goal of sustaining life by all medically effective means Such conversations could start happening right now over the phone. Emergency and ICU physicians may be inundated with patients, but there are many physicians whose clinics have been effectively shuttered by the COVID crisis: ophthalmologists, surgeons, perhaps even your own primary care provider. Many of these MDs were trained in medical school to have end-of-life discussions, even if they no longer do it on a regular basis.
Even in this current setting of vast uncertainty, an advance directive gives us time to consider our options thoroughly, before the urgency and fear of critical illness have taken over our ability to think clearly about our values, goals, and plans for the future—both life and death. It’s important to emphasize that everyone has the right to choose Option A—whether it will be available to everyone is a different matter.
France Dernières Nouvelles, France Actualités
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