In eighth grade, I wrote a 10 page history paper about end-of-life decisions. I called it “Birth of a New Death,” and thought that part of becoming a grown-up was preparing for your eventual death by talking with loved ones and filling out the relevant legal paperwork so that the process was as loving and dignified as possible.
On one particularly beautiful day in high school, walking by the pond, I remember thinking I would be happy if poof my life ended then (but I’d also be happy if it didn’t, and I didn’t feel like ending it). This thought pops up occasionally in beautiful moments.
I’ll start a grown-up contemplation now. I admit to my eighth grade self that my aversion to hospitals and legal paperwork has grown. But consider this a formal document describing my thoughts and wishes for end-of-life care. Traditional “Advance Directives” require extra doctor visits and gatherings of witnesses, which are not wise in this pandemic. Instead, I am using a password-protected github website where I can commit version-controlled files.
The following questions are taken from New York State’s “Advance Directives: Making your Wishes Known and Honored,” and are meant to guide healthcare decisions on my behalf if I become unable to make decisions for myself. The answers are from and about me (Emily Mackevicius): as with other contemplations, others’ thoughts will differ from mine.
Health care proxy: If I become unable to make my own health care decisions, I would like my husband Joseph Olson to make any and all health care decisions for me. If he were unwilling, unable, or unavailable I would like my sister, or my parents, to fill this role.
1. Would you want your doctor to withhold or withdraw medical treatment, if that medical treatment will only prolong dying? Yes, please.
2. Would you want cardiopulmonary resuscitation (CPR) to restore stopped breathing and/or heartbeat? Yes, if the doctor estimates a >25% chance of me recovering. But if they are asking, I’d guess CPR won’t help, and you have my blessing to say no.
3. Would you want to continue mechanical respiration, i.e. use machines to keep you breathing? Only if the doctor estimates this would increase my chances of recovering within two weeks by >25%. By recovering, I mean, recovering to a point where I could make medical decisions for myself. If they are asking, you have my blessing to say no. If it’s been two weeks and I’m still not in a state to make decisions for myself, please stop the machine.
4. Would you want tube or intravenous feeding and water? Only if the doctor estimates this would increase my chances of recovering within two weeks by >25%. If they are asking, you have my blessing to say no. If it’s been two weeks and I’m still not in a state to make decisions for myself, please stop.
5. Would you want maximum pain relief even if it hastens your death? I don’t care. I anticipate being slightly interested in the dying process, but not to the extent that I would want to prolong it.
6. Would you want to donate your organs and/or tissues? Yes, please! But if it’s a hassle, don’t worry about it.
Additional thoughts: Keep telling jokes and thinking they are profound. As you can imagine, it’s unsettling for me to think about this “Advance Directive” being followed, or, slightly worse, not being followed, but I’m proud that it now exists.