Let’s talk about end of life decisions.
As we get older, it’s inevitable that many of us will start to think about our own death – mainly in terms of those we leave behind – getting our financial and business affairs in order and making provisions for our loved ones. But how many of us actually take the time to think about our end of life decisions? And, beyond deciding what type of send-off we want, what does this term actually mean?
Choices
End-of-life decisions refer to the choices we are able to make regarding the type of medical treatment or care we get when facing, for instance, an illness or disability that severely affects our quality of life, or when we come close to the very end of our lives.
So do we want to continue receiving treatments that are there to prolong our lives, such as chemotherapy, surgery or artificial ventilation – with all the possible side effects and discomfort that they can bring? Or do we decide on palliative care, where the emphasis is on pain relief and making what’s left of our life as comfortable as possible?
Clearly, there’s a lot to think about here, and while we may never know exactly how we would feel if faced with, say, a terminal illness or a major disability, our end-of-life decisions are key because they can affect our quality of life and help ensure that our wishes are respected.
By talking things over with our family and loved ones, we can make these decisions in advance, ultimately giving us more control over our treatment and care. This can also help to ease the burden on those closest to us who could be left having to make those difficult decisions on our behalf.
Mental Capacity Act
Here in the UK, the Mental Capacity Act 2005 sets out the legal framework for making such end of life decisions for those individuals who may lack the capacity themselves. Within the act, any decisions relating to medical treatment and care must be made in the best interests of the patient, and take into account the patient’s wishes, feelings, beliefs, and values. It would also need to involve close consultation with the patient’s family and the healthcare professionals providing the treatment.
Where to start
As we discussed, talking to to your loved ones first is really important as it gives you the chance to explain clearly what your wishes actually are so that they can fully understand, respect and support them. You should also talk to your doctor or healthcare provider as they can help you understand the treatment options – and with explain the potential benefits and risks associated with those treatments.
Advance Directive
Here in the UK, you can set up what is known as an Advance Directive – also known as a “living will” in England and Wales. This is a legally binding document that sets out clearly your healthcare wishes and treatment choices. And if you become too incapacitated to make those decisions for yourself, it can then be used to direct the decision-making.
LPA
Choose a person who will be willing to act as your Lasting Power of Attorney (LPA). An LPA is a legally binding document allowing you to appoint your chosen person to make decisions on your behalf should you become unable to do so. Clearly, it’s important that you choose someone you totally trust and who understands your wishes and act in your best interests.
Review and update
The decisions and choices you make today may not be the same further down the line. So it’s important to review and update your end-of-life decisions regularly so that they continue to reflect your true preferences and wishes.
Legal professional
When considering making your end-of-life decisions, it is important to seek the advice of a qualified legal professional who can advise you on the best options for your particular situation – and on what you can or cannot do depending on what part of the British Isles you live in.
It’s also worth noting that, currently, here in the UK there is no legal provision for assisted suicide, remaining a criminal offence under the Suicide Act 1961, and punishable by up to 14 years in prison. There are, however, calls for a change in the law to allow assisted dying for terminally ill patients who meet certain criteria, but to date, no changes in the law have been instigated.
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