of what quality of life he may lead? Even if he needs more care, but does not conflict with his wishes regarding life support, can his wife "pull the plug?"
AmyGrace, what you wrote shows how important a healthcare proxy can be in end-of-life decisions. A proxy speaks for the patients when he/she can no longer speak for themselves. The proxy knows what the patient wants, so can advise the doctors more clearly on executing the advanced directive.
A very good example of this is my parents. My father had been wishing for death. I was his acting healthcare proxy, so knew that he did not want CPR to try to revive him when he died. We followed his DNR. On the other side of things, my mother also has a DNR, but I know she doesn't want to die just yet. If her heart stopped beating today, I would request that they try to get it started again, even though she has a DNR. A healthcare proxy (or healthcare POA) is important, because they understand things better than the piece of paper. Sometimes a form can be filled out when it isn't really relevant, so may not reflect the present wishes of a person. The proxy can do that. (Problems arise, however, when the proxy acts on their own wishes and against the wishes of the patient. There is a clause to ignore the proxy in this circumstance, but it is a very difficult ones for doctors, who will probably opt for the most conservative option. It avoids lawsuits and bad feelings.)
A DNR is a different animal than a Living Will. A paramedic, at least in Illinois, will pay no attention to a Living Will. A DNR has to be a special one signed by a doc before paramedics will not resuscitate.
Doesn't a DNR cover life threatening events when they happen such as stroke, heart attack, etc where the patient stops breathing or having a heartbeat? In which case, the health worker should do nothing to bring them back. In my mind, stopping life support is different and falls under Health Care Proxy where the proxy gives someone permission to make medical decisions for them if they are unable to make a decision themselves (unconscious or mentally deficient) Even so I doubt it includes withholding treatment which will result in euthanasia of a recovering patient - well, maybe in Oregon where they do have some sort of euthanasia law (but not sure if it applies to a relative making that decision).
No, you cannot determine quality of life for him. The advanced directive typically states that no heroic measures should be taken if there is no chance of recovery. If the prognosis is that the patient will recover and have some quality of life, then the directive will not be considered relevant at the moment. If the patient would continue in a comatose state and require continued life sustaining procedures, then the advanced directive would be considered. The situation Maggie described where there was kidney failure is an excellent example of when an advanced directive should be followed. Maggie, I know your father was grateful for being released from such a painful life.
Example: my father had a terrible stroke nine years prior to having another. He had also developed severe, crippling, tears-in your-eyes back pain that required heavy doses of morphine -- making him bed-bound in intensive care in the hospital. He was temporarily on breathing apparatus. His kidneys stopped working requiring dialysis. His wife, after getting the reluctant approval of their children, "pulled the plug." Dad died peacefully in his sleep in the ICU two days later.
I was dad"s cheerleader. He had never executed a Living Will. He'd been married to my stepmother for 25 years. He would not have wanted to live that way. No doubt. The DOCTOR took her and I aside and said, "When I get yo the end of my life, I pray I have two strong women just like you say my side."
Believe me when I tell you no one has ever said anything as powerful to me before or since.
I'm not clear as to the exact situation . I think two things must be present to "pull the plug". The doctor has to determine that there is no chance for recovery and further treatment and life support are futile and ther should be a directive such as a living will, DNR, or POA granting someone the power of end of life decision.
If the doc determines that there is 6 months or less of survival hospice can be called in to make the patient as comfortable as possible during these last months.
If a DNR is in place requesting no resuscitation, ventilator etc then you should probably not have to worry about "pulling the plug" because he will not reach that point and will die from the effects of the stroke. If you are saying he has already survived a stoke and is temporarily on life support but is expected to recover it is doubtful the doctors would even offer to discontinue life support. Once the crisis is past and the prognosis for recovery is good it falls more into the realm of euthanasia, and aside from being illegal most doctors will not even consider going there.
A very good example of this is my parents. My father had been wishing for death. I was his acting healthcare proxy, so knew that he did not want CPR to try to revive him when he died. We followed his DNR. On the other side of things, my mother also has a DNR, but I know she doesn't want to die just yet. If her heart stopped beating today, I would request that they try to get it started again, even though she has a DNR. A healthcare proxy (or healthcare POA) is important, because they understand things better than the piece of paper. Sometimes a form can be filled out when it isn't really relevant, so may not reflect the present wishes of a person. The proxy can do that. (Problems arise, however, when the proxy acts on their own wishes and against the wishes of the patient. There is a clause to ignore the proxy in this circumstance, but it is a very difficult ones for doctors, who will probably opt for the most conservative option. It avoids lawsuits and bad feelings.)
Example: my father had a terrible stroke nine years prior to having another. He had also developed severe, crippling, tears-in your-eyes back pain that required heavy doses of morphine -- making him bed-bound in intensive care in the hospital. He was temporarily on breathing apparatus. His kidneys stopped working requiring dialysis. His wife, after getting the reluctant approval of their children, "pulled the plug." Dad died peacefully in his sleep in the ICU two days later.
I was dad"s cheerleader. He had never executed a Living Will. He'd been married to my stepmother for 25 years. He would not have wanted to live that way. No doubt. The DOCTOR took her and I aside and said, "When I get yo the end of my life, I pray I have two strong women just like you say my side."
Believe me when I tell you no one has ever said anything as powerful to me before or since.
If the doc determines that there is 6 months or less of survival hospice can be called in to make the patient as comfortable as possible during these last months.