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Questions & Answers: Advance Directives and End of Life Decisions

Medical Treatments and Your Advance Directives What are life-sustaining treatments?

Life-sustaining treatments are medical procedures that replace or support a failing essential bodily function (one that is necessary to keep you alive). For example, a ventilator (respirator) supports the breathing process; dialysis cleans the blood in case of kidney failure. They are also sometimes called life-support or life-prolonging treatments.

Why would I not want life-sustaining treatments?

If a good chance exists that a life-sustaining treatment will improve your condition (e.g., temporary use of a ventilator to support breathing until you are able to breathe on your own), you might accept the treatment.

However, if your condition is complicated by many problems (e.g., serious brain damage, kidney failure) and continues to deteriorate with no likelihood of recovery, you might not want life-sustaining treatment.

Furthermore, if treatments sustain life but do not provide the quality of life or dignity you wish to maintain (e.g., your condition is irreversible and you are completely dependent on others for all aspects of care,), you might not want life sustained under these conditions. On the other hand, because of personal or religious views you might want treatments continued as long as possible.

Medical decision-making often requires weighing the benefits of continued treatment against its burdens. By letting others know when, in your view, continued treatment would no longer be a benefit to you, you provide guidance to those who may at some time be called upon to make difficult decisions for you. When a person can no longer participate in these decisions, advance directives may offer the only guide to weighing the burdens and benefits of continued treatment.

Note: In making decisions about treatment, patients or their agents need to know the diagnosis (the exact nature of a person's medical condition) and prognosis (what is likely to happen because of that medical condition). The patient or the designated agent has a right to this information, and needs the information to make decisions properly. If physicians cannot provide an answer right away, find out when they will know more.

How can I learn more about the benefits and burdens of different medical treatments?

First, you should talk with your doctor. If you have a chronic or serious medical condition, your doctor should be able to tell you about treatments that might be especially relevant to your condition.

WebMD Medical Reference from the National Hospice and Palliative Care Organization

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