Children Stick With Decisions Made About Dying Parents
The study results are no surprise to Norman Ables, Ph.D., professor of
psychology at Michigan State University and past president of the American
Psychological Association. "These are such excruciating decisions made
under such stressful situations, it seems most people wouldn't want to change
their minds about it," he says -- mainly because people want to believe
they did the right, best thing for their loved one.
"The difficulty, of course, is you can't always tell when the end of
life is going to occur," he adds, as some terminally ill patients can
linger for weeks or even months.
Given the complexities involved in these decisions, one physician recommends
families discuss their own mortality. "You don't have to anticipate getting
Alzheimer's tomorrow, but you do have to anticipate the possibility of getting
into a car accident tomorrow," says Lissy Jarvik, MD, PhD, professor
emeritus at the University of California, Los Angeles.
She says those discussions should take place relatively early -- perhaps
when the children have reached their twenties -- and that if a living will has
been executed everyone should know where it is. "At the last minute and
under pressure, often the living will can't be found," she says, "and
the children don't know one exists."
And in most cases in the U.S., one won't exist. According to John Banja,
PhD, an associate professor in the department of rehabilitation medicine at
Emory University in Atlanta, only about 25% of patients have one -- and in some
situations they offer no protection. For example, "[there is no protection]
when a family member can't tolerate the idea -- even with a valid living will
-- that a health care provider is going to discontinue life-prolonging
treatment," Banja says. Threats to sue often follow, and he says
"invariably" the health care provider backs down.
An even more powerful legal instrument is the Durable Power of Attorney for
Health Care. It gives another person power over medical decisions, and its
scope goes beyond that of the living will. Banja says while the living will
only covers three prognoses: terminal illness, persistent vegetative state, and
irreversible coma, the power of attorney covers other situations in which a
patient may be extremely sick.