How to talk to patients about a living will?
So this week’s post is in response to the flood of emails I received on the Supreme Court petition filed by the Government of India and it’s ruling. Everyone kept texting and writing saying, “have you see this?” And I had to take time to read the entire petition which allows people to seek passive euthanasia. Well, I’m Catholic and my stand on this is clear. And if people already had advanced health care directives, none of this would be required.
So how do you handle these discussions with patients?
Start at the very First Visit
We all know this is something people are uncomfortable talking about. Nobody wants to admit they’re going to die at some point. We delude ourselves thinking we’ll be here forever. And then no doctor wants to upset patients especially if they do not like admitting they’re old. We’re all like that. Which is why this is something that should be discussed during the first walk-in. You have a new patient, you get the complete history, do the physical, don’t simply ask them whose your emergency contact. Talk to them about the living will.
Make it Mandatory
I’ve worked with certain institutions that have made it mandatory to do this. After all, if we’re your emergency care provider we need to know what advance directives or the living will state, whose the decision maker, who knows and represents your wishes, who calls the shots. Without this, the further appointments won’t be scheduled. Although the ruling of the SC does say in the end the team of doctors decides if brain function is present or not and if life support can be maintained, but in cases where there is function and relatives want to do otherwise, a living will would be great.
Give People Time
Don’t expect it to happen overnight or in the same visit. Get the conversation started. Offer patients time to think about their living will. Let them process this and get back to you.
Meet with the Representatives
If patients tell you that their wife or husband is their representative named in the will, then try and meet with them. Get to know them, just to make sure no one is being coerced. This is also so that it’s no surprise to you if and when it’s required. Talk to these people, discuss the will, and address all their queries.
Explain the Will
This is the most important thing of all. I bet lot’s of patients are going to ask this question of their GP’s after this ruling, especially if they haven’t had a family doctor or GP for their annual health needs. Explain what a living will is, explain end of life care, decisions, machines, protocols, procedures and what is required. Repeat if necessary, till the can explain it well to other people. Don’t instill fear but let them know how and why a will helps.
If you’re a doctor who would like to send in a question, you can DM me on twitter @PamelaQFerns or even message me on LinkedIn or simply use the contact form or email me.