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Who decides whether to terminate end of life care?

featimg_2_11The answer may seem obvious.  You, or your designated agent make this decision.  You have prepared a living will and left instructions for your agent to follow or, if you are still able to speak for yourself, you tell the doctors what you want.

In Texas, this is not true.  Because of the Texas Advance Directives Act, a hospital ethics panel – not you or your family – decide whether to end care!

Last October, Evelyn Kelly learned this the hard way.  Her son, David Chris Dunn, a 46 year old former county sheriff had entered Houston Methodist Hospital, transferred from Bayshore Medical Center in Pasadena.  He had a mass on his pancreas and was in renal failure.

He’d been intubated for a month and the doctors had kept him sedated so he wouldn’t disturb the tube in his throat.  Dunn couldn’t verbally respond to questions but he followed his mother’s movements with his eyes and he could nod in response to his mother’s questions.

One day, the chairman of the hospital’s Bioethics Committee told Ms. Kelly that the doctors had met and decided it was time to end David’s medical care.  The hospital ethics committee was going to meet in 48 hours to make its final decision.  Ms. Kelly had made it clear that, as a born-again Christian, she wasn’t going to take her son off of life support.

“From Kelly’s standpoint, every second her son lived was a reason for hope, but for the doctors, it had meant weeks of treating a man who wasn’t showing any signs of improvement beyond simply having a pulse.”

Chris Dunn died in December 2015.

“In Texas, it doesn’t matter what instructions you’ve previously given or what your relatives say:  If you’re in critical condition, you’re dependent on machines to survive and hospital officials decide it’s time to pull the plug, you will die.  And it’s completely legal.”

It’s rare for a patient’s case to end up before a hospital ethics committee only because most patients die before the process is completed.    However, when it does, it’s very difficult to stop the process based on a law signed by George Bush in 1999.

There are several other cases that have been reported.  Here’s one that happened in 2005 when Zee Klein’s 91 year old mother, Edith Pereira, was taken to the Texas Medical Center with a urinary tract infection.  She had brittle diabetes and had gone blind from the disease but her heart and lungs were in good shape, she could still feed herself and she was fairly lucid most of the time.

The family was focused on getting the infection under control so didn’t argue when a doctor put Pereira on a dose of morphine that would keep her unconscious, and thus unable to eat and regulate her blood sugar.  When the medical team told Klein they wouldn’t install a feeding tube for her mother, Klein had a problem.  One of the doctors told her “ We feel that your mother’s spirit is telling us she wants to die!”

Klein was dumbfounded.  She managed to have her mother transferred to another hospital where she lived for about six months before dying.

Be sure you know what’s legal in your state and be prepared.  For more information about advance healthcare directives and living wills, go to www.diesmart.com.


Who has your healthcare power of attorney?

A healthcare power of attorney is the document where you name the person who will make medical decisions on your behalf when you are unable to do so.  Equally as important as having this document is telling your family who it is and why.

A legal battle started a short while ago disputing whether Sumner Redstone,  the 92 year old titular leader of both CBS and Viacom (who earned a combined $24 million in compensation from the companies in fiscal 2014), still has the mental capacity to make informed decisions.

The suit was brought by Manuela Herzer, a former companion to Mr. Redstone.  The two dated between 1999 and 2001 and, according to her, still maintain a close relationship.  She was legally designated as the person to make Mr. Redstone’s medical decisions.  However, in October, new documents were executed that stripped her of this power and named, instead, Phillippe Dauman, Redstone’s longtime lawyer and CEO of Viacom.  In court filings, Ms. Herzer claims that Mr. Redstone does not have adequate mental capacity to replace her and has asked the court to make him undergo a medical evaluation to prove her point.

Most of us don’t earn $24 million dollars in one year and don’t have the kind of net worth of Sumner Redstone.  However, the point is still as valid for you and me as it is for him.  If you make changes in your healthcare power of attorney or other legal documents that relate to who can make decisions on your behalf, it’s a good idea to tell those involved so they will be aware of what you’ve done and why.

For more information about a healthcare power of attorney and other estate planning documents, go to www.diesmart.com.

California passes right-to-die law

131754-gov-jerry-brown_1This past week, Governor Jerry Brown of California signed a bill into law that makes it legal for a dying person to end his or her life.  When Brown signed the bill, he also released a letter to the state assembly explaining why he agreed to sign it.

He said, “The crux of the matter is whether the State of California should continue to make it a crime for a dying person to end his life, no matter how great his pain or suffering.  In the end, I was left to reflect on what I would want in the face of my own death.”

“I do not know what I would do if I were dying in prolonged and excruciating pain,” Brown wrote. “I am certain, however, that it would be a comfort to be able to consider the options afforded by this bill. And I wouldn’t deny that right to others.”

The law requires that patients are able to administer the life-ending drug themselves.  Also, their decision must be submitted in written form, signed by two witnesses and approved by two doctors.

California becomes the fifth state to have a right-to-die law.  New Mexico, Oregon, Vermont and Washington are the others.

For more information about end-of-life decisions, go to www.diesmart.com.

Looking for a unique pet memorial?

SPACE DOGMany people either bury their pet or have it cremated and keep the ashes on a shelf in their home. However, if you like extravagant gestures and have recently lost a pet, we’ve found something that might interest you. Celestis Pets advertises “the most unique pet memorial service in the universe” and it certainly sounds like it. The company offers memorial space flights for your pet’s ashes. You can choose to just send them to space and back for less than $1,000, send them around the earth with an orbit voyage for about $5,000 or, if you feel very extravagant, send them into deep space or to the moon for $12,500. For more information about people as well as pets, check out our website www.diesmart.com.

Why you need a living will & healthcare power of attorney

terri schiavo

Most people don’t like to think about what will happen if they’re in an accident or come down with a catastrophic illness.  They don’t decide who they want to speak for them if they are unable to communicate their wishes themselves.  They don’t tell anyone what kind of care they want….or don’t want.  Once they are hurt or incapacitated, it may be too late.

These are three reasons why you need a living will and a healthcare power of attorney:

1) You name the person you want to speak for you when you can’t.  It should be someone  you trust to make decisions on your behalf and to carry out your wishes.

2) You decide whether you want heroic measures performed to prolong your life if there’s no chance of recovery.

3) You outline the type of treatment you want to receive.

If you don’t have these documents, a relative you don’t know very well and don’t trust or possibly the courts will speak for you and decide what will happen.

For example, they may decide to put you on life support and prolong your life even though there is no chance of recovery and you may not have wanted heroic measures.  They may choose to perform a surgical procedure that you don’t want or they may decide to do something that is against your religious beliefs.

A living will enables you to describe the kind of care you want.

A healthcare power of attorney (It may be called something else in your state or it may be combined with a living will) allows you to name the person you want to be your healthcare agent who can speak for you when you can’t.

Unfortunately, a life threatening accident or a catastrophic illness can occur at any time.  There’s no age that is exempt.  Think of Terri Schiavo.  She was a 26 year-old that had a tragic fall, went into a coma and remained alive, hooked up to a feeding tube, in a vegetative state for more than 15 years because her husband and her parents couldn’t agree on her treatment and she hadn’t legally stated her wishes.

Don’t let others decide for you.  If you don’t have a living will and a healthcare power of attorney, get them drawn up right away so your wishes will be carried out and you will be able to speak for yourself….even when you really can’t.

For more information on this important subject, go to www.diesmart.com.