Page 54 - Hampton Roads Winter Spring 2017

54 ASK THE EXPERT
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alive, as well as other decisions such as pain infections to be treated aggressively or
management or organ donation. would you rather let infections run their
course?
In determining your wishes, think about
your values, such as the importance to you • Comfort care (palliative care) includes
of being independent and self-sufficient, any number of interventions that may be
and what you feel would make your life not used to keep you comfortable and manage
worth living. Would you want treatment to pain, while abiding by your other treatment
extend life in any situation? Would you want wishes. This may include being allowed
treatment only if a cure is possible? to die at home, getting pain medications,
being fed ice chips to soothe dryness, and
Have discussions with your primary care avoiding invasive tests or treatments.
doctor, your health care agent, family and • Organ and tissue donations for trans-
friends about your personal wishes. Re- plantation can be specified in your living
sources for organizing your own thoughts will. If your organs are removed for dona-
and having conversations with others about tion, you will be kept on life-sustaining
medical care and end-of-life care are avail- treatment temporarily until the procedure
able through the American Bar Association, is complete. To help your agent avoid any
the Conversation Project and the Center for confusion, you may want to state in your
Practical Bioethics. living will that you understand the need for
You should address a number of possible this temporary intervention.
end-of-life care decisions in your living will. • Donating your body for scientific study
Talk to your doctor if you have questions also can be specified. Contact a local medi-
about any of these issues: cal school, university or donation program
• Resuscitation restarts the heart when for information on how to register for a
it has stopped beating. Determine if and planned donation for research.
when you would want to be resuscitated by Do Not Resuscitate and Do Not Intubate Orders
cardiopulmonary resuscitation (CPR) or by
a device that delivers an electric shock to You don’t need to have an advance direc-
stimulate the heart. tive or living will to have do not resuscitate
• Mechanical ventilation takes over your (DNR) and do not intubate (DNI) orders.
breathing if you’re unable to do so. You can make your preferences known to
your physician, who can write the orders and
Consider if, when and for how long you
would want to be placed on a mechanical put them in your medical record.
ventilator. If you have a living will, however, be sure to
• Tube feeding supplies the body with nutri- mention whether you have a DNR or DNI
ents and fluids intravenously or via a tube order on file.
in the stomach. Decide if, when and for For more information on Advance Care Plan-
how long you would want to be fed in this ning, see the “As you Wish” ad on page 46.
manner.
• Dialysis removes waste from your blood
and manages fluid levels if your kidneys no
longer function. Determine if, when and
for how long you would want to receive
this treatment.
• Antibiotics or antiviral medications can
be used to treat many infections. If you
were near the end of life, would you want