Little Sheets of Paper

Tonight my Dad is in the rehabilitation center following knee surgery. From what I gather this is a little like giving birth; it is awful for mother and child but both are really happy a few weeks later.

Upon admission, transferring from the hospital and full of pain medications, a vast array of paper was placed in front of him requesting his signature. Some was about insurance, some about care, and some could end his life.

These little sheets of paper included a health care directive to physicians that gave the facility permission to end his life had he checked a box that said so. Four days after surgery and still in considerable pain, I question his competence to make a reasoned decision. The directive is green in color; green for “go”.

Because my mother was there she stopped the process until I could arrive. Upon my arrival the nurse explained again to my parents, and me, the purpose behind the health care directive was “so the doctor would not have to read through all the legalese of a more complex document” . That is literally what she said during her remarkably practiced speech for all incoming patients.

In other words the Doctor has no time to understand the intent of the patient about whether he lives or dies as expressed when contemplating these issues in a competent, sober manner while consulting with his lawyer who then drafted the same based on the law and his experience.

Just check the box on the little sheet of paper sir, it is better for all of us. That’s right, the green one. Green for “go”.

4 comments on “Little Sheets of Paper

  1. Angela says:

    wow. such bad practice on the part of the hospital. makes me shudder to think how many people would be too quick to check the box.

    • In my practice I hear the following story is so regular I believe it to be more than anecdotal.

      “They were taking great care of Mom just great until I produced this little green sheet of paper” ( sometimes it is no more than a 3X5 card ) “then everything stopped, and they let her die.”

      When my best friend was dying his neurosurgeon took me aside to tell me my health care power of attorney Doug had signed was the best he ever saw, because we had taken the time to draft his intent, and we had a savings clause allowing his brother, the attorney in fact for health care, to make informed health care decisions based on information we could not possibly contemplate sitting in my office.

      As a result we allowed Doug to live a little longer, we were allowed to have a bit more hope, then accept he was never coming back. His was not a medical-industrial complex death because he and his lawyer didnt just check a box. And that, my dear Angela, is what lawyering is really all about.

  2. Debbie says:

    Does checking that box override a patient’s prior directives regarding his/her health care? I mean, does it take precedence over a person’s already-signed instructions on keeping them alive at all costs? Seems like a tricky way to handle a life-and-death issue to me.

  3. In my experience there is a good chance the third party encountering this later signed document may have a good faith reason to treat it as a revocation or modification of the prior instrument, and act accordingly.

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