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No, seriously, I have several legal questions on medical directives that
I'll ask one at a time.
Specifically for Texas, I understand that I would use a Medical Power of
Attorney to designate somebody to decide when and if to end life support
machinery and permit me to die.
I believe in Texas that if there is no Medical Power of Attorney, then
the doctor(s) must consult with the next of kin. This amounts to a
default Medical Power of Attorney.
I thought that for me the default would be adequate, however, a health
care person informed me that in case of family squabbles it is not as
empowering as an actual Medical Power of Attorney.
Comments please. I should think that if people are going to squabble it
wouldn't matter how athoritative a directive is. Was the health care
person correct?
(the name and email address are fictitious)
Dick
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Dick Peavey wrote:
Specifically for Texas, I understand that I would use a Medical Power of
Attorney to designate somebody to decide when and if to end life support
machinery and permit me to die.
I believe in Texas that if there is no Medical Power of Attorney, then
the doctor(s) must consult with the next of kin. This amounts to a
default Medical Power of Attorney.
I thought that for me the default would be adequate, however, a health
care person informed me that in case of family squabbles it is not as
empowering as an actual Medical Power of Attorney.
Comments please. I should think that if people are going to squabble it
wouldn't matter how athoritative a directive is. Was the health care
person correct?
An authoritative medical POA or other similar instrument designates who
is the hightest authority according to your wishes. The squabble, in its
absence, may be who is conforming most to your wishes. For example, if a
wife and brother disagree, who is the doc to believe is adhering closest
to your desires? If you get specific and say the brother is the one,
then the doc can, within good medical ethics, either ignore the wife or
give her voice less weight.
-paul
ianal
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On Mon, 06 Dec 2004, "Dick Peavey" <me@privacy.net> wrote:
[Am I right to believe that in] Texas, . . . I
I understand [c]ould use a . . .
. . . properly/clearly drafted and signed/witnessed . . .
. . . Medical Power of Attorney . . .
. . . or functionally equivalent like instrument . . .
. . . to designate somebody to decide when and if
to end life support machinery and permit me to die[?]
Yes.
[Is it correct that] in Texas that if there is no
Medical Power of Attorney, then the doctor(s)
must . . .
. . . attempt in good faith to try and, if they are able, to . . .
. . . consult with the next of kin[?]
Yes
This amounts to a default Medical Power
of Attorney.
No it doesn't, unless you just arbitrarily define any/every decision
whether to grant/withhold This or That form of medical care made as a
result of the sort of consultation to which you refer as "a default
Medical Power of Attorney".
I thought that for me the default would be adequate,
however, a health care person informed me that in case
of family squabbles it is not as empowering as an actual
Medical Power of Attorney.
Not just in principle but also in practice, s/he is correct, if the
instrument in question is sufficiently clearly stated and properly
executed/witnessed, depending of course on the events that later arise
which make it important to consider what such a document directs.
[Am I probably correct to] think that if
people are going to squabble it wouldn't
matter how athoritative a directive is[?]
Not if the above a "if"s apply.
(the name and email address are fictitious)
And the Devil is in the details.
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Dick Peavey wrote:
No, seriously, I have several legal questions on medical directives that
I'll ask one at a time.
Specifically for Texas, I understand that I would use a Medical Power of
Attorney to designate somebody to decide when and if to end life support
machinery and permit me to die.
I believe in Texas that if there is no Medical Power of Attorney, then
the doctor(s) must consult with the next of kin. This amounts to a
default Medical Power of Attorney.
I thought that for me the default would be adequate, however, a health
care person informed me that in case of family squabbles it is not as
empowering as an actual Medical Power of Attorney.
Comments please. I should think that if people are going to squabble it
wouldn't matter how athoritative a directive is. Was the health care
person correct?
(the name and email address are fictitious)
Here is a discussion of both Texas living wills and other directives.
Someone who suspects they may be at home as death approaches will also
want to review the discussion of out-of-hospital DNR directives. The
hospital environment allows staff to know in advance what has been
ordered. The emergency medical service that may be expected to respond
should be informed in advance of the DNR directive, and all such
directives should be kept close at hand and easily spotted in the room
with the patient. EMS will normally be dispatched when a death is
reported, regardless of what is communicated on the telephone.
http://www.texashealth.org/main.asp?enorgid=FD16313ECC5746F587B853622D072D1F&level=2&id=DD579008B2CC42419E907944C83DBFE9
If that long links gets choppedup by your news reader, go to:
http://www.texashealth.org/?id=&name=Home
Go down to Health Info and Advance Directives
--
Gerald Clough
"Nothing has any value, unless you know you can give it up."
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I believe in Texas that if there is no Medical Power of Attorney, then
the doctor(s) must consult with the next of kin. This amounts to a
default Medical Power of Attorney.
I thought that for me the default would be adequate, however, a health
care person informed me that in case of family squabbles it is not as
empowering as an actual Medical Power of Attorney.
Who is to say who is the most "next" of the next of kin? I would
prepare BOTH a Health Care Directive and a Medical Power of Attorney (I
have).
The advantage of the HCD is that it takes some of the 'heat' off the
person with the Medical Power of Attorney if your next of kin start
squabbling (and don't think they won't when emotions are in play).
Be sure to consider your Medical Power of Attorney from time to time,
the best person today may not be the best choice five years from now.
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Here is a discussion of both Texas living wills and other directives.
Someone who suspects they may be at home as death approaches will also
want to review the discussion of out-of-hospital DNR directives.
The emergency medical service that may be expected to respond
should be informed in advance of the DNR directive...
I was told several years ago by an Emergency Medical Technician in Texas
that at least some emergency response services will even agree to something
called a 'slow code' for a person with a terminal illness prefering to die
at home. The purpose being to allow the family members present to satisfy
their need to call for an ambulance but the EMT team take their time
arriving to ensure there's no point in attempting a revival when there's a
DNR in place. I'd be interested to know the legality of that.
and all such
directives should be kept close at hand and easily spotted in the room
with the patient.
Some locales participate in a 'Vial of Life' program -- essential medical
information, including a DNR if applicable, are placed in a clearly marked
plastic container in the kitchen refrigerator. The idea is that almost
everybody has a refrigerator and they're easy and quick to find, while a
sickroom for a dying homebound person may tend to get cluttered and
important papers might be hard to find in an emergency.
I have been in a situation here in Texas in which the doctor of a comatose
friend pressured the family (and me, the alternate agent on the Directive)
not to request pain medication for the patient, despite advice from at least
two end-of-life specialist nurses that the patient was probably able to
experience pain from his condition even while in a coma. The clear
instructions in the Advance Directive to Physicians and Family or Surrogate
(the statutory version of a living will in Texas) that the patient wished
adequate pain medication administered even at the risk of shortening his
last hours were of great help to the family in resisting the pressure of the
doctor.
I have also been in situations with my father hospitalized, both before he
executed an Advance Directive and a Medical Power of Attorney naming me as
his agent. In both cases, my father was marginally competent (able to give
answers to questions, but confused and sometimes giving answered informed by
delusional thoughts). Even though we never formally executed the
documents -- never had a declaration by the doctors that he was mentally
incompetent -- the hospital and doctors merely being aware of the documents
and that I was his appointed agent had an effect on the doctors and staff,
with regard to allowing me to remain in the room during examinations, to
assist in answering questions when my father's memory was failing him, etc.
--
Robert
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and with the license come rules and regulations). The
individual has only those technological powers with which the system
chooses to provide him. His PERSONAL power over nature is slight.
198. Primitive INDIVIDUALS and SMALL GROUPS actually had considerable
power over nature; or maybe it would be better to say power WITHIN
nature. When primitive man needed food he knew how to find and prepare
edible roots, how to track game and take it with homemade weapons. He
knew how to protect himself from heat, cold, rain, dangerous animals,
etc. But primitive man did relatively little damage to nature because
the COLLECTIVE power of primitive society was negligible compared to
the COLLECTIVE power of industrial society.
199. Instead of arguing for powerlessness and passivity, one should
argue that the power of the INDUSTRIAL SYSTEM should be broken, and
that this will greatly INCREASE the power and freedom of INDIVIDUALS
and SMALL GROUPS.
200. Until the industrial system has been thoroughly wrecked, the
destruction of that system must be the revolutionaries' ONLY goal.
Other goals would distract attention and energy from the main goal.
More importantly, if the revolutionaries permit themselves to have any
other g
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so that they suit the requirements of the
system.
155. Our society tends to regard as a "sickness" any mode of thought
or behavior that is inconvenient for the system, and this is plausible
because when an individual doesn't fit into the system it causes pain
to the individual as well as problems for the system. Thus the
manipulation of an individual to adjust him to the system is seen as a
"cure" for a "sickness" and therefore as good.
156. In paragraph 127 we pointed out that if the use of a new item of
technology is INITIALLY optional, it does not necessarily REMAIN
optional, because the new technology tends to change society in such a
way that it becomes difficult or impossible for an individual to
function without using that technology. This applies also to the
technology of human behavior. In a world in which most children are
put through a program to make them enthusiastic about studying, a
parent will almost be forced to put his kid through such a program,
because if he does not, then the kid will grow up to be, comparatively
speaking, an ignoramus and therefore unemployable. Or suppose a
biological treatment is discovered that, without undesirable
side-effects, will greatly reduce the psychological stress from which
so many people suffer in our society. If large numbers of people
choose to undergo the treatment, then the general level of stress in
society will be reduced, so that it will be possible for the system to
increase the stress-producing pressures. In fact, something like this
seems to have happened already with one of our society's most
important psychological tools for enabling people to reduce (or at
least temporarily escape from) stress, namely, mass enterta
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have first cooperated with non-leftist revolutionaries, as
well as with leftists of a more libertarian inclination, and later
have double-crossed them to seize power for themselves. Robespierre
did this in the French Revolution, the Bolsheviks did it in the
Russian Revolution, the communists did it in Spain in 1938 and Castro
and his followers did it in Cuba. Given the past history of leftism,
it would be utterly foolish for non-leftist revolutionaries today to
collaborate with leftists.
218. Various thinkers have pointed out that leftism is a kind of
religion. Leftism is not a religion in the strict sense because
leftist doctrine does not postulate the existence of any supernatural
being. But for the leftist, leftism plays a psychological role much
like that which religion plays for some people. The leftist NEEDS to
believe in leftism; it plays a vital role in his psychological
economy. His beliefs are not easily modified by logic or facts. He has
a deep conviction that leftism is morally Right with a capital R, and
that he has not only a right but a dut
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severe damage on the natural world. The continued
development of technology will worsen the situation. It will certainly
subject human beings to greater indignities and inflict greater damage
on the natural world, it will probably lead to greater social
disruption and psychological suffering, and it may lead to increased
physical suffering even in "advanced" countries.
2. The industrial-technological system may survive or it may break
down. If it survives, it MAY eventually achieve a low level of
physical and psychological suffering, but only after passing through a
long and very painful period of adjustment and only at the cost of
permanently reducing human beings and many other living organisms to
engineered products and mere cogs in the social machine. Furthermore,
if the system survives, the consequences will be inevitable: There is
no way of reforming or modifying the system so as to prevent it from
depriving people of dignity and autonomy.
3. If the system bre
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In article <srs8r0l7od41tt0dhbu7ffsttuo3c1hvtj@4ax.com>,
Dick Peavey <me@privacy.net> wrote:
I believe in Texas that if there is no Medical Power of Attorney, then
the doctor(s) must consult with the next of kin. This amounts to a
default Medical Power of Attorney.
There may be decisions that can be taken by someone with a Medical
Power of Attorney that cannot be made otherwise (other than by the
patient, who I'm assuming is incompetent at this point).
Seth
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