By E. Roberts Musser
There was a recent article that appeared in the Journal of the American Geriatrics Society (JAGS December 2011-Vol. 59, NO. 12 Autonomy When Doctors and Daughters Disagree), in regard to the limitations of advanced health care directives (AHCDs). A case study cited in the article is illustrative of the difficulties inherent in these problematic legal documents.
An 83 year old woman with multiple and massive health problems, completed a legal advanced directive at her primary care physician’s office, expressing a wish to forgo intubation and any attempted cardiopulmonary resuscitation should the need arise. Once this elderly lady did become acutely ill, she was rushed to the emergency room for medical treatment. Emergency personnel asked the family for permission to intubate, and the woman’s two daughters agreed. This was done despite the patient’s previously expressed wishes to the contrary, which all parties were well aware of.