Almost every one in the audience at the January 15 Casas Adobes Forum stood up as requested when speaker Bill Killian asked how many had an up to date will and had designated a Financial Power of Attorney. Only one person remained standing after Killian's further questions: How many had an Advanced Directive, a Living Will? A Medical Power of Attorney? A Mental Health Power of Attorney?
Killian drew on his long experience as a hospital chaplain and an ordained Methodist minister to explain the importance of those documents at a time when medical technology and medical ethics intersect with personal preference, leading to tough choices when a patient is no longer able to make decisions regarding health care. He distributed copies of a sample directive and explained the listed options.
Then Killian named factors that should be considered when health care decisions must be made:
E --- Every one involved in a discussion of medical care in end of life situations has an opinion --- values that are brought to the discussion.
T --- The medical facts are most important. You can't give an opinion unless you know the facts. What is the physician trying to say?
H --- "Health care decisions must be made as close to the physician-patient dyad as possible. We don't want the Legislature, the Courts, the Church, clinical case history and medical literature, and self-appointed 'do gooders' making the decision. We want the patient making the decision in consultation with their health care team."
I --- Individual autonomy is pre-eminent but sometimes must be balanced with
C --- Community welfare concerns that may trump individual ones.
S --- Scientific technology and moral imperatives must be reconciled.
