Hazel McHaffie

limited resources

Decisions in a time of coronavirus

Week 2 of the lockdown because of Covid-19 and I am reflecting back on an extraordinary seven days. Unprecedented. Grave. Frightening. But one of the most unexpected developments has been a positive one, closely connected to my professional interests: people have been thinking and talking about the ethics around end of life care, and specifically about Advance Directives, teasing out the kind of interventions or treatments they would wish to avoid.

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I wrote my own living will years ago, and have revisited it periodically just to be certain it reflects my sustained wishes. It does. My husband and children have known about the documents and their contents ever since I drafted them, but suddenly these matters seem much more urgent and relevant. There’s a greatly increased possibility that I might become seriously ill soon; that I or they might be called upon to decide whether it’s appropriate or not to accept aggressive or invasive treatment. That it might be futile. So, this week I sent copies of my Advance Directive to refresh their memories as to the detail. If they’re called upon to represent my views, they will know precisely what to say.

However, more importantly, this crisis has prompted other people I know to think about their own mortality and how they feel about these issues, for the first time. Sobering stuff. But so right.

At the very least we all need to have the conversation with our nearest and dearest; better still record our decisions, have them officially witnessed, make the documents known and available.

And the questions even for hardened ethicists have been widened and thrown into stark relief by developments during this pandemic:
what if our hospitals are already full, and I can’t be admitted if I succumb to the virus?
what if being admitted to hospital means I risk dying alone?
what if I live alone and I contract the illness?
what if I fall outside the criteria for treatment?
what if the medics deem me to be highly unlikely to survive?
what if it’s a choice of me versus another patient?
what happens if no-one can attend a funeral?
… and so on …
This public health catastrophe and its horrific statistics has brought us face to face with undreamed-of dilemmas confronting our society in the spring of 2020. Now.

The time has never been more urgent for a weighing up of the risks and benefits, and an analysis of our beliefs and values. For having the conversation. It’s personal. It’s real. It’s not going away.

What will you choose?

 

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