The Marlise Munoz case reinforces my belief that everyone has the right to determine what kinds of health care treatment they want and do not want when faced with medical crises.  And, most importantly, that everyone consider writing down their wishes with as many details and scenarios as possible … and then share those wishes with everyone, from family members to friends to spiritual advisers to lawyers to doctors and other healthcare providers.  Obviously, no one can contemplate everything that could possibly happen to render oneself unable to communicate or make decisions to accept or refuse medical intervention.   But to contemplate nothing may bring about situations where no one has control over decisions.

When stories like Mrs. Munoz’s are traipsed across the nation via our sensationalizing media for every Tom, Dick and Harriet to offer an opinion, I wonder if those offering an opinion also take the time to examine how they would want to be cared for.  Maybe their opinions indicate the kind of care they would want.  It may be too late to make decisions if we wait until we are faced with the situation first-hand.

So, rather than get caught up in the very opinionated debate swirling around these kinds of cases, I would hope that each individual starts thinking about their decisions if faced with a “brain dead” situation.  These are some questions I have thought about for myself:

• Would I want to be connected to machines that would breathe for me and pump blood through my body even though I don’t consider that “living”?  What if the life-support was determined to be needed only short-term (like after a car accident) with full recovery expected?
• Does everyone in my circle understand my thoughts about brain death and how I would want decisions made if I am declared brain dead?
• If I was connected to life support, would I want my family forced to make the decision to disconnect or would I rather give them specific, written instructions to carry out my decisions?
• In my decision-making process, can I anticipate or understand the emotional turmoil of my family keeping vigil over me in a mechanized state?
• How much decision-making heartache will be avoided if I write things down and talk about it with my loved ones and my doctors?
• Would my deliberations include consideration of the possibility that a long-term existence on life support might financially bankrupt my family?
• Would I expect my family to be embroiled in a legal/court battle to remove life support that was initiated against my wishes?

People often make vague statements like “I don’t want to be a ‘vegetable’” or “Pull the plug” or “Do everything” without any explanation of specific situations or steps for loved ones to take on their behalf.  Statements like that are really of no use to people standing around the bed of a dying (brain dead?) loved one.  Only with frequent conversations and written decisions will family members be able to advocate for your care if you are unable to do so for yourself.  Imagine the anguish and expense that might have been avoided for the Munoz family if only their conversations would have been shared with others and written down.  Hopefully the fact that Mr. and Mrs. Munoz, who are in their early 30s, will emphasize that advance care planning is important for everyone, not just for the elderly (which seems to be a common thought).

Caring Choices is ready to meet with all of the generations of your family to help you navigate these conversations and put health care decisions in writing.

(c) 2014 Caring Choices