tag:blogger.com,1999:blog-32053362.post906148723186927694..comments2024-03-29T05:39:11.334-04:00Comments on Not Running a Hospital: My Mom's wishesPaul Levyhttp://www.blogger.com/profile/17065446378970179507noreply@blogger.comBlogger14125tag:blogger.com,1999:blog-32053362.post-42506875071914023982008-10-03T18:32:00.000-04:002008-10-03T18:32:00.000-04:00wow i was impressed. Thank you so much for sharing...wow i was impressed. Thank you so much for sharing your story it is people like you that make the world a better place. Take care and god bless.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-13156297617656871422007-05-23T11:22:00.000-04:002007-05-23T11:22:00.000-04:00Paul, I too have had the honor of fulfilling my Mo...Paul, I too have had the honor of fulfilling my Mom's Advance Directive, and she died a month ago. To me, acts like yours and your sisters are the most respectful thing we can do for our loved ones. I'm also aware that even knowing that doesn't lessen the loss. My condolances on this anniversary of your Mom's passing.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-37361636279465902392007-03-16T15:37:00.000-04:002007-03-16T15:37:00.000-04:00If you want a good example of why a health care pr...If you want a good example of why a health care proxy and living will are improtant then look at the Schiavo case. Would she have wanted to be kept alive in any way possible with the hope fo some day coming out of the coma as her parents stated or would she have preferred to be removed from all live support systems and allowed to die as her husband stated. No one knows. Many see the husband as a sleeze who after waiting for so many years for her to come out of it moved on with his life, but that doesn't mean what he said was not true. We don't know her true wishes and never will. Don't put your family in that position.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-87979264036960731142007-03-16T15:31:00.000-04:002007-03-16T15:31:00.000-04:00Its not enough to just name someone as your proxy ...Its not enough to just name someone as your proxy or to be named a proxy. It is important for both parties to completely understand what is expected should the need for the proxy to make decisions arise. The whole idea of the proxy and living will is that an individual is essentially making the decisions about what steps should or shouldn't be taken to care for them if they became unable to make the decisions. It takes quite a burden off the shoulders of loved ones who are thrust into a position of making important decisions and wondering what the patient would want. And in many cases, it pits family members against one another because some are looking to make one decision and others the exact opposite. And in some of those cases, the decisions aren't being made in the patients best interests but the interests of decision makers.<BR/>My parents have both a health care proxy and living will and they have explained to us on many occassions what their expectations are. When my father was recently diagnosed with stage four lung cancer (see Paul's previous entry on the blog) and treatment was failing we were prepared to follow his wishes. We were fortunate enough that he was of sound mind when the decision was made to move to palliative care. He was the one that made the final decision. We followed his directions when he was unable to make the decisions on his own.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-32497322447047591602007-03-15T11:49:00.000-04:002007-03-15T11:49:00.000-04:00Thank you for the information. I guess I'll dig o...Thank you for the information. I guess I'll dig out my living will and get a proxy as well. I thought I read that Massachusetts recognized one more than the other.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-40617324696129974512007-03-15T05:01:00.001-04:002007-03-15T05:01:00.001-04:00I have just found your wonderful blog. Don't alway...I have just found your wonderful blog. Don't always agree with you but the dialogue is interesting. In reading through a number of posts at one sitting--including ones about hospital acquired infections, apology and medical malpractice, I wondered how BIDMC handles situations in which one of your patients dies from a HAI? Do you apologize? Do you hold your breath and hope the hospital isn't sued? Do you tell the family these kinds of deaths just happen? How are you thinking about the intersections of these issues?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-53996364948861642762007-03-14T13:13:00.000-04:002007-03-14T13:13:00.000-04:00You are a rare CEO to have this blog and your topi...You are a rare CEO to have this blog and your topics are relevent and provacative. I have linked my EverythingHealth blog site to yours. Keep blogging, Mr. Paul.Toni Brayer, MDhttps://www.blogger.com/profile/15258759363309666629noreply@blogger.comtag:blogger.com,1999:blog-32053362.post-3377881527188898542007-03-14T12:16:00.000-04:002007-03-14T12:16:00.000-04:00Paul, I think between you and Blog, MD I have foun...Paul, I think between you and Blog, MD I have found my two favorite new blogs of 2007. <BR/><BR/>My husband works in a nursing home. he sees families every day demanding that he g-tube a 98 year old dying alzheimers patient (he's a speech pathologist/swallowing specialist).<BR/><BR/>it breaks his heart every day. <BR/><BR/>we both have made our intentions very clear.<BR/><BR/>thank you for sharing the professional and personal experience that you do... it is greatly appreciated.Christine G.https://www.blogger.com/profile/17781551364340088590noreply@blogger.comtag:blogger.com,1999:blog-32053362.post-60558037851309791952007-03-14T11:26:00.000-04:002007-03-14T11:26:00.000-04:00Just to clarify about living wills in MA, it is co...Just to clarify about living wills in MA, it is correct that they are not legally binding. However, it would be unusual (and incorrect in my view) for a physician not to consider & respect treatment preferences outlined in a living will.<BR/><BR/>It is a very good idea to have a health care proxy. But it's essential for people to discuss with their proxy what they would and would not want in terms of care for the end of their life, or for a situation where the chances of recovery are slim. As a doctor, it is distressing when there is a proxy, but he/she can't answer the question "what would the patient tell us he/she would want if he/she was able?"<BR/><BR/>It's important to fill out a form (available at www.massmed.org - put "health care proxy" in the search box), but you really need to have a conversation with your proxy so he/she can understand & accurately represent your wishes if needed.Daniel Sullivanhttps://www.blogger.com/profile/09586773540405557745noreply@blogger.comtag:blogger.com,1999:blog-32053362.post-50449582381629274962007-03-14T11:04:00.000-04:002007-03-14T11:04:00.000-04:00Great post. I think it would also be helpful if p...Great post. I think it would also be helpful if primary care doctors, as a matter of standard practice, addressed end of life wishes with their middle aged and older patients early in the relationship. Find out what the patient wants and doesn't want in an end of life situation, get it in writing, and make it part of the patient's medical record. Perhaps this could even become one of the metrics that payers define as part of good primary care.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-34956414135752121132007-03-14T10:55:00.000-04:002007-03-14T10:55:00.000-04:00A health care proxy is a legal document that allow...A health care proxy is a legal document that allows you to name a person(s) to make health care dicisions for you in the event you are not able to do so. This takes effect only after your physician has determined that you lack the capacity to make health care decisions.<BR/><BR/>A living will is a legal document prepared where an individual can outline specifics in regards to their wishes- i.e.not prolonging life in certain situations, no feeding tubes, etc.<BR/><BR/>Massachusetts is one of the few states that recognizes a health care proxy as the basis for health care decisions and NOT a living will.<BR/><BR/>So here in MA it is important that in addition to appointing your health care proxy, you make sure that your proxy is aware of your wishes in regards to advanced directives. This can be through conversation or through devising a written living will in addition to signing a health care proxy form. http://healthcareproxy.org<BR/><BR/><BR/>Paul- thank you so much for bringing this issue to light on your blog. In geriatrics we see so many families in distress and disagreement about courses of action, because the conversation was not had early enough with their loved ones about what their wishes would be.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-40135077743949792142007-03-14T10:38:00.000-04:002007-03-14T10:38:00.000-04:00Great post - this is something everyone should do....Great post - this is something everyone should do. A Health care proxy is so important as well. Both living will and health care proxy are the best to ensure the wishes of the patient.<BR/><BR/>Thanks for sharing this story.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-26157557797706948252007-03-14T10:22:00.000-04:002007-03-14T10:22:00.000-04:00I think it is both, but maybe a lawyer out there c...I think it is both, but maybe a lawyer out there can comment.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-16511471036883476902007-03-14T10:13:00.000-04:002007-03-14T10:13:00.000-04:00Paul, I'm confused. Do I need a health care proxy...Paul, I'm confused. Do I need a health care proxy or a living will or both.Anonymousnoreply@blogger.com