AHCDs: About Life or Death?

I read Atul Gawande’s Being Mortal: Medicine and What Matters in the End this summer. It wasn’t exactly light beach reading, but I devoured it like candy. 

Given my line of work, I am probably more interested in end of life planning than most. But, for obvious reasons, I think we all should be somewhat interested in the subject, whatever age you are. If you haven’t given it any thought, maybe it’s because you are not yet willing to confront your mortality. I understand the aversion.

But, what if you thought about this taboo topic differently? What if I said that end of life planning does not have to be about death? What if you thought about it as a chance to decide how you get to live your life? In the book, Gawande says: 

“You may not control life’s circumstances, but getting to be the author of your life means getting to control what you do with them.”

All estate planning is about this in some degree, but the concept is really apparent with Advance Health Care Directives (AHCDs). AHCDs allow you to decide who can make medical decisions for you when you cannot make them yourself, and how that person should make those decisions. 

Guiding you in making these decisions should be answering the question, what is important to you in living a meaningful life? What are the trade-offs you are willing to accept under difficult circumstances? In Being Mortal, the answer for one man was that he was willing to tolerate a fair amount of pain if he could still eat chocolate ice cream and watch a football game. This sort of insight was tremendously helpful to his daughter when she had to make some serious decisions about his medical care.

Your thinking about this will evolve over time, and you can always revise your plan accordingly. So, don’t feel like you are locking yourself into a set of decisions if you complete an AHCD. You will make the best decisions you can, knowing what you know now.

There is no better time to do this sort of planning than when you are not in crisis—so consider talking to me about completing an AHCD sooner, rather than later. I can walk you through the options and how to communicate your decisions to your family and medical providers.

I also highly encourage you to read Being Mortal. I am just scratching the surface of substance of this important book.