Source: El Espectador
By: Catalina Uribe Rincón
Medical doctor Asha Shajahan told The Huffington Post the story of a 30-year-old patient who died of COVID-19. The patient, as it normally happens, had not leave any instructions on how to proceed in case of illness or death. When he reached a critical condition, his parents got into a nasty argument. When he saw the statistics, the father advocated for avoiding any treatment that would prolong his son’s agony. The mother, for her part, wanted to do everything possible to keep her son alive, regardless of whether he would remain unconscious and stuck to a ventilator.
Incidents like this are frequent these days. Of the 55 patients that Dr. Shajahan treated for COVID-19, only a 54 old one had already prepared a document with guidelines in case of complications. The rest of her patients had to face really uncomfortable scenarios. When Shajahan, for instance, asked a patient about her guidelines for future procedures, she went into a state of shock: “Is this a bad omen?” Her concern was not inappropriate: her virus infection was already advanced, she was pumped in four liters of oxygen and she was breathing with difficulty. Was her condition critical? No. But there was neither a trace of fatalism in the doctor’s question: it was a simple procedure.
The problem of waiting until we get sick to provide guidelines concerning what we want is that we put ourselves in the worst possible context to make a crucial decision. You don’t want to be connected to a four liters oxygen ventilator and being asked: “Hey, if your lungs collapse, what would you want us to do with you?” Moreover, perverse incentives get generated. Let’s suppose that someone is 70 years old and really determined to leave this world with some autonomy. Does he really want to emphasize to his doctor that he does want to live, but only up to a certain point? With so much loose confusion concerning the allegedly most valuable years of life, it is difficult to argue that what you want the doctor to protect for you is a meaningful life.
And in any case, those two cases are better than the third one, that occurs when the person has not decided, gets worse, and then the State delegates the decision to his partner, siblings or parents. The matter is sad for at least two reasons. First, because having some control over life results in having some control over death. Second, and perhaps more significant, is that if things don’t turn out as expected, you force your loved ones to carry the uncertainty of whether it was your will. And although everyone will tell you, “Don’t think about it,” you hardly control your thoughts in a wakefulness. Why leave the torture of doubt to others?
One recommendation of the health professionals is that all persons should have an “advance directive” document specifying their decisions on whether they authorize limb amputations, resuscitation and advanced resuscitation procedures as the connection to a ventilator, among others. All this is done in order to avoid that “therapeutic cruelty” seeking to preserve life regardless if the person is in a vegetative state or suffers an incurable pain. As long as you are conscious, you can always change your mind. But if you want to have an opinion, it won’t hurt you to be familiar with the guidelines.
Source: El Espectador
https://www.elespectador.com/opinion/lista-para-antes-de-morir-columna-916364
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