Wednesday marks the 7th annual National Health Care Decisions Day. Amid setting up our spring wardrobe and stuffing our faces during Passover and Easter, today we are meant to take time and consider the importance of making health care choices before it’s too late. The creator of the national day of observance, health care attorney Nathan Kottkamp, believes that there is no better day than today to make important choices regarding our future health care.
National Health Care Decisions Day was created to help educate the public about advance care planning. This is a three-step process that involves: considering the decisions that need to be made at the end of life, discussing one’s preference with family members, and recording those wishes in some form of advance directive. In the advanced care planning process, treatments to be considered involve both cardiopulmonary resuscitation and mechanical ventilation. Artificial nutrition, fluids, and comfort care are also factors that need to be taken into consideration. “Ninety percent of ethics consults I have been involved in deal with end-of-life decisions without advance directives,” Kottkamp told Reuters.
Although the ultimate outcome of considerations is a living will and durable power of attorney for health care, it is not the main objective. Kottkamp simply wants to get people talking about what their wishes are in the event that they fall seriously ill. “It has to start with the conversation,” Kottkamp explained to Reuters. “It can end with a piece of paper, but it’s the conversation that matters.”
A report by the California HealthCare Foundation found that if seriously ill, most people would want to speak with their doctor about end-of-life care. Based on a recent Reuters article, the report also found that less than 10 percent of those had this conversation. In individuals aged 65 and older, less than 13 percent already had this conversation. A survey by the Pew Research Center found that more than 42 percent of Americans have had a friend or relative suffer from a terminal illness or coma in the last five years. In most of these cases, the issue of withholding life-sustaining treatment had come up.
Dr. Julie Goldstein, a palliative care physician in Illinois, believes that there are such low numbers of people discussing end-of-life health care issues because enhanced technology and medicine is giving unrealistic expectations of their ability to prolong life indefinitely. “I repeatedly see patients dying in the hospital while families stand by, engaged in wrenching decision-making without knowing what patients really would have wanted,” Goldstein added, in the Reuters article.
Although these conversations may be uncomfortable now, Kottkamp urges that they are even more uncomfortable in a hospital setting. In order to help observe the day, educational events are being planned nationwide. These events are taking place at libraries, hospitals, and other health facilities. Akron Children’s Hospital in Akron, Ohio, has advance directive forms available in the hospital’s public spaces to be signed and witnessed. The event had 25 participants last year and hopes to surpass this number today. “The worst time to talk about what you want is when you’re going through a health crisis,” Lisa Long, the hospital’s palliative care office coordinator told Reuters.