Tuesday, August 4, 2015

End of Life and Medical Treatment - Can I Say What I Want to be Done?

Although it is scary to think about, we all come to the end of our lives. Obviously it would be best if that happened quickly at the end of a long and healthy life but sometimes, all too often, death and dying comes over a prolonged period.

That raises the question of treatment while you are ill. Can you legally make plans in advance of such illness setting out what you want to be done if you are not well enough to tell the doctors?

In most of Canada you can prepare something called a power of attorney for personal care or a personal directive; these documents are often called "living wills". Such a document can set out in detail the directions you want doctors to follow should you be too sick to tell them yourself. A power of attorney for personal care or personal directive also says who the doctors should ask for treatment authority if you are unable to give direction. Nunavut does not have legislation allowing for powers of attorney for personal care or personal directives (NWT does so it's not clear why we don't) - but that does not mean you cannot make provision for a future illness.

The Courts step in to fill gaps where there is no legislation.

Judges have ruled that every competent adult has the right to be free from unwanted medical treatment. That means that if you clearly set out your wishes in anticipation of circumstances where you may be unable to say what you want a doctor is not free to disregard such advance instructions, even in an emergency.

Since we do not have legislation setting out the way to make your wishes known we have to improvise. It's not ideal but if you write down what you want, sign and have the paper witnessed and dated by two people you have probably done the best you can. It's important to let your family know your wishes and, if you can, to tell the health centre in your community also about your wishes.


Bruce McMicking said...

When Dad died all they could legally do was stop feeding him and let him starve to death. He asked the doctors if they could help him on his way and was told something to the effect of, "I'm going to pretend you didn't ask that." Luckily, at the end, he was unconsious on heavy doses of morphine, but he still took a week to die.
His final two weeks were spent at home and it fell to his family to dose him. We all considered trying to overdose him to end his suffering but thought we would get nailed for that. In the end no one ever checked on how much morphine was left and didn't even collect what remained for months. I think they expected we would and were fine with that. I'm sorry we didn't.

I have an aunt who is 102 1/2. She is long since past wanting to be here; seems to hate every minute and if she had the option I think she would choose to go.

Every time I see her I think it's time to take up sky-diving.

Gerald H. M. Schieven said...

Sounds interesting, James. Will you be in Toronto Aug 10 or 11?

Lulymay said...

Recently a situation came up in BC whereby a retired nurse had prepared a living will and felt that should she end up in such a situation, everything was in order and she would not be kept alive against her wishes (when she could no longer act for herself).
She is in 'care' in Abbotsford, BC where the Fraser Valley Health Authority has control. Despite the family's request and even going to court, this poor lady is still being kept alive. The reason? those in control at this Health Authority insist that because when they put a spoon to her lips with food on it, she opens her mouth therefore she is accepting being kept alive. (This is a community considered to be the centre of the Bible Belt in BC.) I am very concerned that I could very well end up in the same situation. Is there any chance that members of the Law Society would consider drafting a Living Will document that protects those who do not want agencies to overrule the wishes of a person such as myself when my family tries to have the terms of a living will adhered to? I'm think of a printed document that could be purchased at a book store or similar agency?