Who Will Decide Your Fate? : Medical Interventions

So, I contact Dr. X, and ask him about what is happening behind the scenes in Aimee's situation.  What is not being discussed in the media?

The first issue Dr X approaches is that of making decisions about medical interventions.  He shares with me that the question that the doctors ask whenever they make any medical intervention is the "big question":
 "what does the patient want?"

If the patient is able to answer that question directly, when they are conscious and clear in mind, then the doctor listens to what they say and does as they request.  The issue gets complicated when the patient cannot state their choice, and when the doctor has no written statement by them, such as a living will or a DNR (do not resuscitate).  (Take note I am providing wikipedia links to these terms so that you can read about them in more detail)

Then the question is "what would the patient have wanted?"  That question inherently scares me, as I don't know many people that would know what I would have wanted.  Frankly, I haven't ever thought much about it myself.  To answer this question the doctor turns to the next of kin.  The next of kin is usually a spouse.  If the person is not married, as is the case with Aimee, then the next of kin becomes the living parents, if there are any.  

So behind the media cameras, back in a private office in the hospital, there is a doctor who is discussing the situation with Aimee's next of kin, her father Andy.  And, Andy is the one who is attempting to most accurately answer the question "what would Aimee have wanted?"  Note: the question is NOT "what would you like for Aimee?"

This question arises at every step of intervention.  Whatever is needed, from antibiotics to breathing support, from blood to amputations, the doctors do as they are told.  The doctors have to present a full list of option, and one of the options that has to be verbalized is that of doing nothing.  Doctors have to give the option of doing nothing.  

The doctor has ethical and legal parameters as to their involvement in decision making and action.  After giving intervention options, at least in the more significant decisions of the hundreds of them that happen in such situations, they have to clearly document the choices they gave and the decision that the next of kin came to.  These records, if documented clearly and timely, are considered golden in the eyes of courts.  They are proof enough that the doctor offered such options.  Additionally, those larger decisions need to be signed off on by the next of kin.  I had no idea how well documented the hospital room is.

With that information as background, the question then becomes, how well can one's next of kin reflect what you would have wanted?  Or, in this case, how well does Andy reflect Aimee's wishes?  That is impossible to say.  However, Dr X said that on this topic that Aimee, as an unmarried adult, is in one of the categories of patients who likely are not understood as well by their next of kin.  When discussing how she might have preferred to not live given the situation, and of course this is conjecture not fact, he said "that's what happens when you're not married."  He suggested that unmarried adults make their best friends as next of kin, rather than the default of their parents, as those who you choose to have in your life and spend your days with often know you world-view and values better than your parents.

From the articles and photos on the web, Aimee might not be religiously aligned with her father.  Aimee might, and again I emphasize this is conjecture for the sake of examining the issue only, not have faith in the Christian ways of her parents, but rather a more holistic spiritual approach.  Along with this holistic approach to spirituality might be the ideas of reincarnation, or something like that.  To quote one such position: "there is no birth, there is no death, there is only the process of formation and transformation."  Another one I found online read something like for a spiritual person who passed: "Never born, never died, just visited this planet Earth between... this date and that date."  I have no idea if she would subscribe to such thoughts.  But, if she did, who would be the best person to answer the question "what would she have wanted us to do in this situation?"

I am married, and I trust my spouse to know what I would want.  In the situation that Aimee is in today, I would want to go.  

I asked my living parents what they would want, if I were became next of kin for them.  They both said that in this case, they would want to go.  My mother said, "I wouldn't want to be dependent upon anyone."

My spouse also would want to go.  In fact, everyone that I asked this question to said they would want to go.  Everyone.

When my body shuts down and tries to take exit, when instrumental parts of my body would need to be amputated, I would not want machines keeping me alive.  I am not so attached to my life, I am much more attached to my quality of life.  I would not want to endure the suffering.  I would not want to wake up in a hospital bed to see 1/3 of my body missing.  I would not want that trauma.  No thanks- it is not for me.