Making decisions about your death
Is advisable as the law will fall in favour of prolonging life
Anticipatory decision making, the process of making health and welfare decisions for a time in the future when we may lack the capacity to make them, presents difficulties that are practical and philosophical. Two papers published in the BMJ and Student BMJ (BMJ 2011;343:d5528; Life, p 16) reflecting on real life cases, explore these difficulties.
Towards the practical end lies the question of the weight that should be given to decisions made by patients in advance of losing capacity. In what circumstances should a patient’s prior wishes prevail? Does, for example, the statement “do not resuscitate” tattooed on an unconscious patient’s chest amount to a binding advance decision? Daniel Sokol and colleagues encountered such a patient. The 22 year old woman needed resuscitation after extensive burns, but had a tattoo on her chest which read “DNR, do not resuscitate.” The patient’s notes contained no advance directive, and the team were