I am assuming that the issue I’m about to raise is not purely personal, but rather one that could affect most of us and that feminists probably have illuminating things to say about it. I take it that the form I’m describing below is absolutely standard. I am now inclined to think it would be a bad idea to sign it, and I cannot understand why it is the standard form, when the general advice is that one sign one.
So I am looking at with the possibility of filling out an “Advance Directive,” which specifies what I want to happen when I am “unable to make medical decisions about myself because of illness or injury.” My understanding is that the directive has legal force and it has to be notorized, witnessed and so on.
It has two major clauses. One starts “if, in the judgment of my physician, I am suffering with a terminal condition from which I am expected to die within six months, even with available life-sustaining treatment provided in accordance with prevailing standards of medical care.” The second is similar except that it is about being in “an irreversible condition so that I cannot care for myself or make decisions for my self and am expected to die without life-sustaining treatment…”. One’s choice is to keep the life-sustaining going or to have it cut off, with the understanding that suffering is to be minimized in the latter case.
The picture that initially comes to mind is that one is lying comatose and on a ventilator. However, “life-sustaining treatment” can cover just medication. Blood thinners needed to prevent a stroke presumably can count as life-sustaining. Procedures like dialysis would also be included, I think. “Irreversible conditions” include those that can be managed even if not cured.
The “my physician” sends off alarms for me. The directive gives one physician the power in effect to decide whether my life is worth living. One might think that the directive applies only when one is mentally incapacitated, but it is more accurate to save that it applies only when someone decides one is mentally incapacitated. Nothing specifies whether the incapacity is temporary or permanent.
In addition, there are situations when one can have a temporary mental inability; for example, in the case where one arrives at a hospital incapacitated from a stroke, damage from which one can nonetheless be lessened greatly with swift medical intervention. Apparently cystitis can make old people mental incompetent as can being moved around a hospital, which the elderly can find extremely disorienting and confusing.
Given the evidence suggests that white men are more likely to have life-sustaining interventions, I think there may be a concern with this standard form for people of color, white women, and perhaps most elderly.
I should add that I have had one personal experience with such a situation. My 86-year-old father was in a hospital because he had a heart attack. He was sort of minimally rational and got disoriented when he was moved around. The question arose whether he should be discharged with life-saving medication that had a particular downside or not. He was completely and entirely cut out of the decision-making even when he became much more rational.
So what do you think?