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The Most Important Conversations

I am sorry.
Please forgive me.
Thank you.
I love you.

From Hoʻoponopono - an ancient Hawaiian
practice of reconciliation and forgiveness

Conversations2.jpgThanks to the marvels of modern medicine, death is often a long and agonizing process. It is essential to acknowledge the possibility of prolonged dying, learn about it, think about it, and most importantly discuss it with your family and even your closest friends. What would be your wishes should you become terminally ill, with only a few months to live? Do you want to be kept alive at all costs, or would you want your life to end when the quality of living is not acceptable to you?  Or something in between? 

And, what if you suddenly take a turn for the worse and can’t speak for yourself? Who is going to speak for you? Does this person know what your wishes are? 

Part of the thinking-ahead process must include discussions with others. It is important to discuss your thoughts on what you want at the end of life with your partner, your children, your physician, your minister, priest or rabbi, and others close to you.

There are several reasons to have conversations about the end of life. Here are a few, the first being the most critical (list quoted from Final Exodus: Planning for End of Life):

  • Conversations1.jpgShould you become incapacitated and lie in a coma in an emergency room, or any hospital room, the attending physician, not likely your personal/primary care physician, will turn to those family members standing near and say something like, “Your loved one is seriously ill. Here are the options for treatment: A, B, and C. What do you want me to do?”  The family needs to know how to respond to that question.  Moreover, the family needs to be in agreement. The last thing you want is to lie there helpless while your loved ones argue about how to respond to the doctor. Such family disputes sometimes end up on the courts, even the U.S. Supreme Court. The only way to avoid arguments is for you to be sure everyone close to you understands your wishes.
  • Conversations are a way for you to clarify your own thinking. Others may make points that you hadn’t thought of. You might change your mind.
  • After an in-depth discussion, a family member may still not agree with your wishes and might well argue against them should he or she be called upon. You need to keep such a person from being involved in your health care decisions. 

How do you do that? The second important element in planning ahead for the end of life is executing an advance directive (in some states called a living will with power of attorney for health care). In this document you do two basic things: (1) you state your end-of-life wishes, and (2) you designate someone to officially speak for you when you can’t speak for yourself. Before you designate this person, called a proxy or agent, you must have an in-depth conversation with him or her not only as to what your wishes are but also what reasoning lies behind them. What led you to make your particular choices?

Now you are ready to take the next step, that is, to execute an advance directive or living will with power of attorney for health care. If you are reluctant or uncertain about having these end-of-life conversations, here are some web sites you can visit that will help you get started.