By Timothy S. Barkley, Sr. February 2015.

“I don’t want to go through what Mom went through.” Pause. “I don’t want to put my kids through what we went through when Mom died.

“When Mom had her heart attack, the ambulance crew did CPR and tried to bring her back, then the ER doctors hooked her up to all kinds of machines. When we showed them the living will, they said they had to go over it, and it took days, almost a week, for them to decide that it was OK to turn off the machines.

“I don’t want to be hooked up to machines, and I don’t want CPR. If I’m going, I just want to go!”

The tall man across the table nodded sympathetically, thoughtfully. “But I was talking to a client the other day who said that when her mother had her first heart attack, she and her brother didn’t feel right about discontinuing life support, and her mother recovered and had ‘three or four good years’ before the second heart attack. Her mother thanked her for not ‘pulling the plug.’

“When Mom had the second heart attack, they knew it was right to turn off the machines, and Mom went peacefully.

“The question is, will you have your heart attacks in order? Not to make light of a serious subject, but how do you know you won’t recover and have your own ‘four good years’? Not everybody who has a heart attack ends up a vegetable. Most people get better!”

Short pause.

“But I don’t want my kids to have to worry about that. It’s a hard decision.”

Again the nod. “But isn’t that what family is for? To make the hard decisions when they need to be made? When your kids were little, you made hard decisions for them – beginning of life decisions. Is it their turn? To help you with end of life decisions?

“Anyway, when did Mom die?”

“Fifteen years ago.”

The attorney gestured, “Remember, too, that we’re in a different situation than years ago. For one thing, hospitals and doctors are used to seeing these papers, for better or worse, and don’t worry as much about legal problems if they do what the papers tell them to do.

“For another, a well-drafted Advance Care Directive – what we used to call a living will – is coupled with a document appointing a medical agent – someone to make medical decisions for you if you can’t. That way the doctor is just doing what your agent directs, and isn’t as worried about liability.

“If you’re worried about your medical agent and doctor knowing what care you want to receive, you can also download the MOLST form – it’s an acronym for ‘Medical Order for Life-Sustaining Treatment’ – from marylandmolst.org.

“The MOLST replaces what we used to refer to as a DNR order. You can download the form and go over it with your loved ones, especially your agent, and complete the form. If you include it with your Advance Care Directive, it will guide your medical agent in directing your care. If you think it’s appropriate, you can also go over it with your doctor and have him or her sign it and include it in your chart – that way it is a true medical order and will direct your treatment.

“Often, the issue is not so much ‘do we hook you up,’ but ‘when do we unhook you.’ If you go in for major surgery, you’re probably going to be connected to life support just to make it through surgery.

“So we’re trying to anticipate two situations – the crisis and the aftermath – in end of life decisionmaking. Make sure you think about both as you make your plans.”


Attorney Tim Barkley
The Tim Barkley Law Offices
One Park Avenue
P.O. Box 1136
Mount Airy
Maryland 21771

 (301) 829-3778

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