Heart surgery patients should make end of life plans

Patients undergoing heart surgery ought to create a Living Will beforehand, to guide their care in the event that they can no longer articulate their wishes. Patients undergoing complicated and risky treatments, such as aortic valve replacement, are at a considerable risk of death or suffering other complications related to the surgery, such as stroke and heart rhythm problems. In fact, recent studies suggest about a third of people who undergo such a procedure will die during the two years after surgery. The high death rate suggests many people will have to face up to difficult decisions following the procedure. A Living Will should be an integral part of such advance planning. In addition to ensuring patients receive care that’s in line with their wishes, a Living Will reduces the burden on family members who would otherwise make those decisions. Medical professionals should do more to make patients undergoing any type of surgery, but in particular surgery with a high likelihood of complications, aware of Advance Decisions and Living Wills, and should encourage them to register their own Living Will with the UK Living Will Registry. Further Reading: http://uk.reuters.com/article/2014/08/05/us-advance-directive-heart-surgery-idUKKBN0G526620140805 http://www.reuters.com/article/2014/07/29/us-advance-directives-health-idUSKBN0FY1VV20140729 If you don’t have an advance directive, the UK Living Will Registry urges you to get started today. A well written Advance Directive, like the one we provide, can ease the burden on your family and ensure that you spend your final days in the dignity of your own choosing. We also highly recommend that you go one step further and register your Advance Decision with us. We are the only national registry of Advance Decisions and Living Wills...

Letter to the Irish Medical Times

There ought to be a central living will registry Dear Editor, As someone who has written a living will, I was interested in Gary Culliton’s article of April 11 (‘Doctor concerns over living wills’). Our treatment at the time of death is probably one of the areas most neglected in modern medicine, where death is regarded as an enemy rather than the friend that it can often be. My big concern is that if I were to collapse away from home, how could those treating me know of my living will? I would suggest that there should be a central registry where such documents could be stored. If those who had made such a living will carried a card to this effect any treating physician could access that document before embarking on procedures that the patient concerned may have stated specifically that they did not wish to be carried out. I would suggest that it should be the responsibility of the Department of Health to set up such a registry. Dr Conor Carr, Ballinasloe, Co Galway.   Fortunately, such a registry now exists: The UK Living Will...

Advance decisions on medical treatments likely to catch on

Advance decisions (also referred to as Living Wills), in which people specify what medical treatment they want close to death if they ever become unable to make such decisions for themselves, will become more common. Already in the United States, a record number of people are completing such documents. Between 2000 and 2010, the proportion of people with advance directives rose from 47 to 72 per cent. As the world’s population ages and end-of-life health care costs spiral with more advanced methods of keeping patients alive – but not necessarily improving their quality of life – their use is highly likely to grow. Not only are advance directives good for individuals because they help them to make health care decisions for themselves and remove stress from their families; but they are also good for the health care industry because they have the potential to cut costs significantly. Terminally ill people’s wishes should be respected, and those who choose to opt out of treatment if the prognosis is particularly bad ought to be allowed to do so. The principle is patient autonomy. Currently, lack of familiarity to advance directives, coupled with many complicated, unresolved issues surrounding them, mostly due to ignorance or misunderstanding, make advance directives a thorny area. Nonetheless, what is certain is that the current legal framework that governs the use of advance directives warrants a lively debate to make the statutory framework less ambiguous.   Further reading:...