The Hardest Question: Who Draws the Line?

In this Covid-19 epidemic, a wrenching question especially demands an answer: if you or someone you love is taken down into life-threatening illness, how far would you want extreme life-prolonging measures to be tried?

For us who are particularly vulnerable – seniors, those with compromised immune systems, those already struggling with medical conditions – this question is particularly stark. Many people are familiar with DNR orders, “do not resuscitate.” These are intended for cardiac arrest. The threats posed by the current virus, though, more often implicate breathing problems. The longer time spent on a ventilator, the greater the chances of permanent damage, disability or death .

Many are dying alone, without their loved ones present. The New York Times recently reported on a particularly heartbreaking case.

Most people over sixty with a serious illness say they would prefer to be kept in comfort at the end, even if that care shortens life. But where to draw the line? How much time alive would you be willing to sacrifice, to decline aggressive treatment and possibly die sooner? The need to provide at least some answers is important not just for you. Clinicians and caregivers need guidance, too.

A 2017 study showed that approximately two-thirds of Americans had neglected to provide prior guidance by creating advance health-care directives like health care powers of attorney and living wills. Back then, most of us could not have imagined being in an epidemic like the one now.

Even if you or your loved ones have already done the responsible thing and created advance directives, now is the time to review those documents to make sure they reflect what you want under current conditions.

Health-care providers are ethically obligated to do everything feasible to keep us alive. If we have no advance directives in place, the system will take over – and families can end up in long-lasting anguish for having had to be the ones to make the final call. Don’t let that happen. Think through the question for yourself and talk with a person whom you trust to make that decision for you if need be. Call us for your advance health-care directives – and may you and yours not need them for a good long while.