When it comes to our health, we typically do not think about being so sick or injured that we would be unable to speak for ourselves. But, a health crisis can happen to anyone and at any age. In fact, three of the most famous cases in medical ethics involved young and previously healthy women: Nancy Cruzan, Karen Ann Quinlan, and Terri Schiavo. Recently, Bobbi Christina Brown, daughter of Whitney Houston and Bobby Brown, has also been in the news.
Advance Directives are documents that can guide health care teams when individuals are unable. Each and every one of us should complete one, beginning at age 18. By far the most important thing that can be accomplished with an Advance Directive is the appointment of a health care agent — also known as a health care proxy or power of attorney — for health care. A health care agent is someone who knows you well and can speak for you when you can’t speak for yourself. Here in Vermont, no one is automatically assigned this role (such as a parent, spouse, or adult child). The agent is not making the choices, but is applying his or her knowledge of you to voice what you would choose for yourself, if able.
These documents are simple to complete, and can be found online. In Vermont, we have a wonderful organization, the Vermont Ethics Network (VEN). The VEN website contains information about Advance Directives and other health care decision making, and you can download and complete an AD. Once completed, patients should be sure to give a copy of the AD to their agent, loved ones, primary care physician, and their local hospital. You can also mail the AD into the Vermont registry where your document will be stored and accessed by hospitals if you are away from home.
Each year on April 16, National Healthcare Decisions Day is celebrated. At The UVM Medical Center, we are hosting events for our patients, families, visitors, and staff to complete their own documents at various locations around the hospital and in medical practices. We invite you to talk to your loved ones and think about who you might chose to serve in this most important role.
Sally Bliss, MSB, RN, is a clinical ethicist at the University of Vermont Medical Center.