Hi Julia
I obviously didnt express myself well. I suspect we fully agree.
Hello lindsayf. Sorry if I've misunderstood what you were saying.
The advocate is the person appointed under the advance care directive to advocate for the person if and when they no longer can do so for themselves( which is the whole point of the ACD process of course). That person is hopefully carefully selected so that they CAN be an effective advocate and will hopefully not be subject to family conflicts etc that you rightly say are quite common.
I think you are confusing an Advance Health Directive with an Enduring Power of Attorney. They are quite separate documents and fulfil different, if complementary functions.
With an Advance Health Directive, you do not appoint anyone to speak for you if you are unable to do so.
The document itself serves this purpose. It is completed in conjunction with your doctor and clearly spells out what life saving measures you do or do not want to be taken, should you be unable to speak for yourself.
As I've said before, it is a legally binding document in Queensland.
It is many pages in length and deals with each potential life saving measure individually, eg do you want artificial respiration, do you want artificial feeding/hydration/antibiotics. There is absolutely no room for doubt on the part of any medical practitioner reading the document. It also gives additional space for extra comments which the patient feels are not adequately covered in the formal document.
The patient completes his/her section of the AHD, then takes it for consultation with his/her GP. The GP checks each section, questioning the patient in detail, and finally - being assured of the patient's clarity of mind in completing the document - co-signs it, attesting to the patient's ability to make a proper decision.
End of story.
An Enduring Power of Attorney is a document giving permission to any chosen person or persons to make decisions on your behalf should you be unable to do so. This can encompass health decisions (in which case you would make clear that an AHD exists and that your attorney(s) have a copy of that document, plus financial, and real estate decisions, essentially any life decision you would make for yourself were you able.
Obviously, your attorney(s) will be people with whom you have clearly discussed all your wishes and whom you feel assured will be competent to act as your advocates should the (hopefully unlikely) need ever arise.
Your general practitioner and your local hospital should ideally hold copies of both these documents on their files, and of course the attorneys should hold both documents also.
Hope that clarifies the value of both quite separate documents which complement each other.
I think in some states the Qld AHD is known as a Living Will.
Your State Attorney-General's department will have a document which can be downloaded and completed.
It isnt rare for invasive procedures to be suggested by doctors in the context of palliative care ( and even despite the existence of an ACD..at least in Vic/NSW)
Yes, I know this happens, though not usually in the context of palliative care: rather where the patient is admitted to intensive care where their default mode is to use every possible method of prolonging life, often entirely contrary to the wishes of the patient.
and this is a specific situation where the appointed advocate will be able to demand that the persons wishes are respected and refer the doctors to proof of the persons wishes etc.
Correct. And thus we can see the value of the person holding the position of Enduring Power of Attorney also having the AHD as proof of the patient's wishes.
I would argue that in some circumstances the individual does not know when a future situation will be tolerable to them. How can someone possible know that living in a wheelchair, or having to wear a prosthesis, or wear a colonoscopy bag, or take a handful of drugs each day for the remainder of their life, or never being able to conceive, is intolerable?
Perfectly easily, Zedd. It ain't hard to imagine being in such a position and understanding with absolute clarity how one would feel about it.
I don't know how old you are? It's perhaps something which becomes very clear as one gets older, sees more of life, and has more personal insight than is possible at a young age.
I'm not suggesting they should have to try it to know for sure,
Well, sorry, but you are, really. If you are going to want to override a perfectly sane person's decision about what they want because you think you know better, then you are in fact condemning them to something they have specifically said they do not want. I have no idea why you think that you should have such a right.
but I don't think people's perception of some of these "disabilities" are accurate, even when given all the available information.
Why on earth not?
Not at all. In fact I'm a firm believer in euthanasia and the patient's ultimate right to choose.
Well, in this discussion you are completely contradicting yourself if that's the case. See above.
I suppose the reason for my first post was because you appeared to be insulted that the consultant presented you with a choice.
No, of course I wasn't insulted. Offering me a choice about my mother's wishes is in no way insulting to me: quite the opposite.
But I was astonished that such a situation could exist.
To be fair to that consultant, he seemed to be just 'going through the motions' , as though he was fulfilling some legal obligation by telling me that, and he in no way suggested that he thought my mother's choice was not entirely valid. On the contrary, he went on to say that she clearly was in full possession of her cognitive abilities and he was entirely prepared to support her decision and ensure her death was as comfortable as possible. It turned out to be absolutely so.
I didn't raise the question in terms of my personal situation, but rather to try to increase discussion about a subject most people seem reluctant to have. Imo we need to acknowledge the reality of death and the dying process, discuss it with our families, instead of leaving it all unsaid, a situation which leads to the current undesirable last minute conversation medical personnel would much rather not have.
I don't just think, but know from experience that I do know what's best for loved-ones in some circumstances, even if they can't see it for themselves at the time. I also know that others have been in similar situations for myself. But, I also hate the idea of not being able to decide for myself, even if it means letting me make my own mistakes...
So, really you are not sure where you stand on this. That probably makes you typical of most of the population.
That's why more of us need to have the discussion imo.
I suppose I was just trying to grey the debate. It's certainly a tough issue.
And I truly thank you for your contribution which I recognise as being sincere, if ambivalent.