Guidelines for End of Life Decisions
Patient, Physician, and Family & Designating a Patient Advocate
Unexpected events happen. These instances may significantly alter our lives, even affecting our ability to make health care decisions or communicate our wishes for treatment. However, just because an event may be unexpected does not mean that we cannot prepare ahead of time. One recommendation for all adults is to consider and formally designate a Patient Advocate. This advocate will be able to direct health care decisions on your behalf and ensure your wishes are followed, only if you become unable to do so yourself.
Whether you are healthy or facing an illness; a young adult, someone entering middle age, or enjoying your twilight years, consider planning for the future — designate a Patient Advocate to ensure that you will be prepared for the unexpected.
A Designation of Patient Advocate is a type of advance health care directive that ensures your intentions for health care are followed in case you are unable to participate in medical or mental health treatment decisions. Michigan Catholic Conference provides its Guidelines for End of Life Decisions booklet and accompanying Designation of Patient Advocate forms as resources to assist you with considering end of life decisions and designating a Patient Advocate, in a manner that is consistent with Catholic Social Teaching.
Table of Contents
Starting the Conversation
For most, death and dying, or even the thought of becoming incapacitated, are not popular or easy topics. Perhaps because we are too busy living life! We feel somewhat invincible. However, why should we consider our own mortality? Well, eventually, the day will come for each of us, when we will leave this Earth and continue our Eternal Life following Divine judgement. We need to be prepared for what comes after death. We also need to be prepared for what may come before it and how we want to be cared for in our final hours or time of incapacitation.
Whether you are the patient, a family member, or chosen Patient Advocate, there are a number of things to consider when deciding upon and executing, or accepting, an advance health care directive. To start, read through the Guidelines for End of Life Decisions booklet and accompanying Designation of Patient Advocate forms to familiarize yourself with applicable Catholic Social Teaching, state law, and the obligations and responsibilities of Patient Advocates.
Then begin the conversation. While discussing end of life decisions may be one of the more difficult conversations to start, it also may very well be one of the most important. Choosing an advocate and discussing your wishes with them is best done well before your Patient Advocate may be required to act. Carefully consider whom to include in the conversations — family, friends, or health care providers — and get started.
“Let me go to the house of the Father.”
Choosing a Trusted, Responsible Patient Advocate
You may choose any adult as your Patient Advocate. When choosing an advocate:
- You should find someone whom you trust and with whom you have discussed your desires and your values with respect to health care issues.
- You should choose someone who is responsible and empowered to make decisions for your care, determining what is best for you, using your known wishes as a guide, while considering the present circumstances.
- You should consider whether the individual will be supportive of you and your desires and whether they will be willing to work together to address any challenges that may arise.
- You may also want to consider your Patient Advocate’s location and proximity to you and whether they will be able to be physically present with you when decisions need to be made.
Discussing Values and Desires in Health Care Decisions with Your Patient Advocate
These conversations are best held in a calm and caring environment. Try to avoid interruptions or anything that could cause a distraction. With sensitive topics to be covered, privacy is also important. Trusted individuals and Patient Advocates included in the conversation should listen carefully to your values and desires and avoid being critical, judgmental, or confrontational. Additionally, Guidelines for End of Life Decisions can help provide you with consistent principles for all Catholics to consider when making health care decisions. You may specifically want to talk through the obligations and responsibilities of your Patient Advocate, as well as the types of health care decisions they will be empowered to make on your behalf by reviewing the booklet and forms together.
Your Designation of Patient Advocate Documents
Once you have executed a Designation of Patient Advocate and your advocate has executed an Acceptance of Designation as Patient Advocate, it is important to retain copies, so these are readily available when needed. In addition to the patient’s original, each of the following should be provided a copy of the forms:
- Patient Advocate,
- Your treating physician,
- Your attorney, if applicable, and
- Appropriate family members.
It is recommended that you keep your form in a secure location in your home, yet where it will be easily retrievable if you need to call 911 or go to the hospital. You may also want to keep with it a list of all those who have copies of the documents. This will help you retrieve the copies, should you decide to revoke or update the document and designation.
“Advance health care directives ensure that your intentions for health care are adhered to in case you are unable to participate in medical or mental health treatment decisions.”
Continuing the Conversation…
The conversation between you and your Patient Advocate should not be a one and done event, especially as things in life often change. Therefore, it is advisable to periodically review and renew your Designation of Patient Advocate and remind your advocate of your expectations for care. This is especially important if you experience any changes in your circumstances, relationships, or health, such as a new diagnosis or a decline in health. Also consider any change in your Patient Advocate’s life that could impact their ability to continue their role.
Finding Additional Catholic Resources
Implementing an advance heath care directive and Designation of Patient Advocate in conjunction with the Catholic Faith is a good start to prepare for the unexpected. However, in the moment, specific circumstances that warrant additional consideration and evaluation in line with Catholic Teaching.
Consultations
Should questions arise based on your individual and specific circumstances, it is recommended that you and your Patient Advocate consult your Parish Priest. Additionally, The National Catholic Bioethics Center offers free bioethics consultations with one of their Ethicists.
The National Catholic Bioethics Center: Ask a Question
If there is concern with the care administered in a health care facility, most hospitals allow you to request an ethics consultation with their ethics committee to discuss your concerns. Depending on the facility, though, their ethics committee may not be familiar with Catholic Teaching. Therefore, it is best to also consult and involve your Parish Priest.
Advance Health Care Directives in other States
Most advance health care directives are state specific, in order to comply with the state law. If you have a loved one in another state, CatholicEndofLife.org is a Catholic resource that provides advance directives from around the country, as well as considerations for end of life decision making consistent with the Catholic faith.
“The Michigan Catholic Conference reaffirms the Catholic Church’s belief in the value and dignity of human life and the respect due to each individual person.”