I am a Palliative Care APRN and Co-Chairperson of our Hospital Ethics Committee. I give presentations on the importance of having “the conversation” frequently. This case hits home as to how beneficial putting it in writing can be. I recently took care of a man who had fallen and developed a head injury, had surgery but unfortunately, it worsened due to a new stroke. The ICU team was asking his daughter to make very difficult, complex decisions related to the rest of his life and she was having a very hard time, as she felt it was all on her shoulders.

Fortunately, she contacted his lawyer at the team’s suggestion, and he had completed an Advance Directive, explicitly explaining his wishes if he were to be in a terminal condition with no hope to return to the quality of life he wanted. The daughter was SO RELIEVED that the decision was NOT hers, but his.

She could now make the decisions knowing she was following his wishes and expressed values, allowing him to die with dignity and peace, not surrounded by machines and tubes or in a prolonged state of poor function in a Nursing Home. Because he put his wishes down on paper, although he never spoke to her specifically, because he took the time to do it, it saved her terrible distress and feelings of guilt.

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