Respecting the Wishes of the Dying: Physician or Medical Orders for Life Sustaining Treatment

Choose life as life is sacred

Your life is sacred and so are the lives of others, when it involves the choice between life and death. Maybe you have suddenly become involved in an emergency, medical scenario or a long-term health care situation, where you have to make a decision about prolonging your own life or that of others. Perhaps you really do not know how to respond. You turn to your physician for advice.

Respecting the wishes of the dying is extremely important to physicians. Many of them, as well as registered nurses and other health care professionals, regard life as being sacred and will do everything they can possibly do to help patients who are dying. Physicians are the experts to consult about how to sustain life, as well as enhance it.

They are also there to assist patients through the difficult decision-making process regarding physician or medical orders about life-sustaining treatment. Physicians routinely give orders to registered nurses and other health care professionals that reflect patients' preferences with regard to receiving life-sustaining treatment.

Note that ideally, all patients will receive life-sustaining treatment from physicians and registered nurses, as well as other health care professionals, unless a physician has given a written, medical order stating otherwise. This constitutes a do not resuscitate order.

A patient has the option of refusing to allow life-sustaining treatment. A patient can also ask his or her physician to write an order stating do not resuscitate. He or she can request to sign a legal document witnessed by a medical professional. The DNR request then becomes part of that patient's chart.

Medical professionals, on all levels of health care, are dedicated to saving the lives of their patients. They attempt to ensure the quality of the lives of the patients. This means that if a patient does survive a medical ordeal of some kind through life-sustaining measures, medical professionals will assist the patient to attain the highest possible quality of life.

A do not resuscitate order or a request by a patient not to receive life-sustaining measures, is always a serious matter. The patient and his or her family must understand what this means in terms of life and death.

Health care professionals face different kinds of medical dilemmas involving life and death, every day. Respecting the wishes of the dying with regard to life sustaining treatment is extremely important to them, as well as others.

At times, patient's wishes can be very difficult to discern, depending upon the patient's level of orientation, degree of awareness, age, comprehension level, extent of a disease process, injuries and ability to communicate.

At times, patients have left specific written directives regarding their personal decisions about the use of life-sustaining measures with other family members or legal counselors, but not always. Sometimes tragic events happen quickly and patients, as well s their families, are unprepared. Life threatening scenarios happen when they are the least expected.

Patients have different mindsets with regard to the use of life-sustaining treatment, when it comes to the reality of keeping them alive by artificial means or allowing them to die with some degree of dignity. There are those who are in favor of life-sustaining measures and others who oppose them. Others may need directives or guidance prior to making a decision.

There are patients who regard life as being sacred and want to live regardless of their quality of life. Their quantity of life is equally important to them.

These patients see their own lives as having value and may attribute the control of life and death to the divine. They will not knowingly participate in measures that inevitably result in their own deaths or that of others. They may request or even insist on receiving life-sustaining measures, regardless of the circumstances.

Many of these patients have been trying to stay alive and live life fully, even while struggling against all possible odds. They cling to their lives. Sometimes they fight for their lives right to the last breath. They want to survive even when they know that they are dying. They hope and pray for miracles. They will not ask for a do not resuscitate order from their doctors or sign a DNR document. Their desire is to live, not to die. Respecting their wishes, family members probably will not sign a DNR on their behalf, either.

On the other extreme, health care professionals deal with many patients, who are attempting to destroy, take or end their own lives, in one way or another. Sometimes, when they senselessly take their own lives, it includes the lives of others. Many of these patients are angry, depressed, mentally ill, confused or fearful of death, but sometimes they are more afraid to live, as they begin to question the quality of life that they will have if they do survive illness, surgery, accidents or other tragic scenarios of different kinds. Some patients want to live; others want only to die. Then there are all of those in-between.

At times, there can be a very fine line between life and death. Questions arise like "What does it mean to 

live?" or "What happens when a person dies?"

Physicians, as well as other medical professionals, attempt to answer questions and do what is right for each patient. For those who are involved in serious, life-threatening scenarios or are dying, there is always hope. 

Sometimes what appears hopeless is not hopeless at all; it just seems that way, at that particular moment in time. Things can always change for the better.

If you are a dying patient, there are many counselors, as well as other professional advisers like ministers or priests, who are able to help you look at your life from a different perspective. You may begin to realize that what you initially thought was your desire for death or your wish regarding not receiving life-sustaining treatment, is not what you really want at all. You want to live and live life well.

It is a good idea to discuss all of your possible medical options with your doctor or other heath care professionals, including registered nurses. They may be able to assist you in ways that you do not expect.

It is a good idea to find out what your family's wishes are. What you think they want, may not be what they want for you at all. You may be pleasantly surprised to find out that you are a very important person in their lives and they want you to live. They may also be willing to help you to cope with anything that is proving to be too difficult for you to deal with, at any particular moment in time.

Be aware that as a patient, you do have rights, as well as options. The choice for life or death is in your hands. Do not sign any legal document, without being fully informed as to what you are signing. Find out what signing a DNR means with respect to the status of your life. Make certain that your family understands this also. Do not make any hasty decisions in this regard either. Sometimes what appears to be the only option is not an option that you would want to consider.

When in doubt about your choice between life and death, always choose life and life-sustaining measures, rather than seeking physician or medical orders that would prevent others from saving your life. Teach others to do the same.