by Craig Klugman, Ph.D.
This week appears to be advance directive week on television. First, on the rebooted X-Files, Dana Scully finds her mother’s advance directive. Second, on Chicago Med a physician ignores not only a DNR, but a patient’s clearly stated wishes not to be resuscitated. One of these presents a model of a good surrogate decision-maker who respects the patient’s wishes. The other shows an arrogant doctor who blatantly ignores patient autonomy.
The X-Files (Season 10, Episode 4) finds Agent Scully at her mother’s bedside after receiving a call from her brother that their mother is in the hospital. Mom is unconscious, intubated, and on a ventilator. Dana tells her brother that he should get on a plane and that it was their mother’s wish to remain on the ventilator so that her children could gather. A nurse walks into frame and tells Dana that her mother wrote a new advance directive in the last 2 years, which states she did not want to be on a ventilator, or intubated. She also wanted a DNR. This new document surprised Dana who wonders why her mother would change her mind and not talk to her about it (besides being an agent, Dana is a medical doctor). The nurse explains that just because they extubate does not mean, her mother will die immediately. In this scenario Dana wanted to keep her mother alive—she wanted the family to have time to say goodbye, she wanted more time with her mother so that she could “ask the little questions,” and because she wanted to understand why her mother changed her end-of-life care choices.
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.