The Importance of Advance Directives and Power of Attorneys

This week I had the privilege of job shadowing in the clinical ethics department at a hospital here in Illinois. In clinical ethics, it is impossible to know exactly what your days will look like in advance, since your schedule depends on the varying needs of others in your workplace. There may be several days in a row where no requests for consults come in, or you may have three come in at a time! Luckily for me, there was a steady stream of consult requests this week.

There are multiple reasons someone could request a consult: withholding or withdrawing treatment, informed consent issues, disagreement among families, etc. But this week the majority of cases had to do with decision-making. If a patient lacks decision making capacity, the health care power of attorney is asked to make decisions on the patient’s behalf. Unfortunately, most people do not have a power of attorney or advance directive, so this leaves clinicians with the duty of identifying a surrogate decision-maker, which can be difficult, especially if a decision needs to be made in an emergency.

This is why it is important to have conversations about what you would want if something were to happen. It doesn’t matter how old you are, appointing a power of attorney or making an advance directive is a wise idea. You never know when something could happen. Karen Quinlan was only 21 when she collapsed and lapsed into a persistent vegetative state. There was a huge uproar when her parents requested that she be taken off of the ventilator.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.