“The New Art of Dying” Review: Protect Your End of Life Wishes
The New Art of Dying by Diane Burnside Murdock
Most of us don’t want to think about dying. But, if we are trying to be responsible, and especially if we have loved ones depending on us, we fill out the paperwork to make our wills, our living wills, our do not resuscitate orders (DNR), and our durable power of attorney, giving someone the right to make medical decisions if we are incapacitated.
What if that isn’t enough? What if there are all sorts of situations that can interfere with what we thought was the plan for our end of life? Diane Burnside Murdock tells a cautionary tale in The New Art of Dying, a book about all those difficult decisions that we really want to avoid.
Murdock points out that most of us have the fantasy of dying peacefully at home, but most people don’t get to live that out. She points out that a large percentage of patients in an emergency room don’t even have the right paperwork to enable a peaceful end. That makes sense. We want to think we are going to live to a ripe old age, not die in a freak accident or sudden illness, so we are not prepared.
Even if we are, there is no way to know that someone will honor our wishes because of the fear of legal consequences. Murdock explains how, for example, if you have a heart condition and decide to exercise at a facility such as the YMCA, you might carry your DNR paperwork with you. However, if you have a heart attack, the YMCA personnel will try to resuscitate you until medical personnel make the decision not to continue. Only a medically licensed person can make that choice. Also, a DNR only means “do not resuscitate” in the event of a cardiac arrest, but if anything else happens, the DNR may not apply.
Another big issue that is touched on in The New Art of Dying is how and when the medical team sees death as being near. Most are taught to perform life saving and life sustaining measures until there are no other options. That doesn’t mean that you want all those heroic measures taken. Many are extremely uncomfortable, even painful. So if you don’t want life saving measures taken, but the doctor believes that your condition is curable, your wishes may be ignored.
Murdock discusses how important it is to designate a person to make medical decisions for you: a person you can be absolutely sure will accede to your desires, a person who truly knows and understands what you want.
Friction is often caused in families when two or more children of the patient want different things. One child may view a feeding tube as essential, while another may view it as life prolonging and not desirable.
It is extremely important to talk through multiple scenarios with the person you dictate to make those decisions, so that the person knows immediately what to do when different situations occur. To side step issues, many states now have a form for “physician order for life sustaining treatment” (or POLST form), which requires a physician’s signature about end of life wishes. You cannot use this if your state does not recognize this document. However, it does provide a new level of legal requirements. If new life saving methods are discovered for your disease or illness, a new form is required to bypass that life saving effort.
Murdock analyzes many case histories in her book, specifically one 90-year-old woman. She had health problems and began acting confused. A sore on her toe caused by lying in bed prompted her loved ones to put her in the hospital. She was given antibiotics, her circulation began to fail, the toe infection progressed, and she was going to lose her leg. The lady had to be put on a breathing machine, IV fluids, and tube-feeding. Her kidneys began to fail, so doctors wanted to remove her leg and perform dialysis. Instead, her family decided to remove the breathing machine and let their loved one go peacefully. Completely unexpectedly, after the breathing tube’s removal, the woman began to breathe on her own. Her family had to make tough decisions on what to do, and the woman finally died from kidney failure.
Interestingly, Murdock discusses how people from non-English speaking families have an additional language barrier to overcome. Non-native English speakers should be prepared to find an advocate who can translate medical procedures, someone who will help you with all legal documents to provide your loved one with the care they want.
ReUnion: Story of Cancer in the Family
The New Art of Dying also mentions doctors who don’t honor a patient’s wishes, even when spoken directly from the patient, because they don’t want to be perceived as assisting a “suicide.” An example is given of a woman in her 50s with cardiac failure who had a ventricle pump put into her chest. Afterwards, she continued to have mini strokes for the next two years and ended up in a wheelchair. She asked the doctor to turn the pump off and let her go if her heart gave out, but the doctor refused. Another doctor who worked with the hospital’s ethics committee convinced the operating doctor that the device should be turned off.
Other issues addressed in The New Art of Dying include medical errors (which result in over 100,000 deaths each year) and medical malpractice. Because of the number of case histories in the book, it is a good way to start a discussion with your loved ones about your wishes or theirs. If anything can be learned, it is that you must plan for the unexpected, make sure you have covered all possible scenarios legally and that you have created the best end of life decisions you can with all the facts at hand.
Author, Diane Burnside Murdock also talks about the wisdom of having an app on your smart phone that can be with you in every circumstance, and saves all your legal documents. Overall well-written and informative, The New Art of Dying is definitely a recommended read for anyone looking for information about communicating their end of life wishes to their loved ones.
Everlasting Footprint wants to help everyone celebrate life and preserve important documents on behalf of your loved ones. Start an Everlasting Footprint for your loved one today, and help save all the things that show why they were important to you.