Making tough decisions

I'm inspired by the content of my last post, combined with some of the content of Ron Blue's Splitting Heirs.

Blue says we need to "love [our] children equally and, as such, treat them uniquely."

Now, that's tough! (Tougher for some than for others.)

I was talking with my dad a week or so ago and he said he found the idea of even attempting to differentiate among his six children overwhelming. I mean, he knows we are different. He knows I have absolutely no need for any portion of his estate, whereas others of my five brothers and sisters are not so well off. He knows that some of us are quite capable of taking care of ourselves, whereas others . . . aren't.

But trying to figure these things out--or even talking about them with his children--seems "just" too difficult.

Blue offers a scenario. I'm not going to get the details all right. But the general picture is what matters:

Suppose you have three children, Blue suggests.

• The oldest, a daughter, is married, professes faith in Christ, lives in the "right" neighborhood, goes to the "right" church, wears--and makes sure her husband and children all wear--the "right" clothes. She and her husband are members of all the "right" clubs and organizations. . . .
• Number two, a son, is married and has children. Their family, members of a "faith" mission in which financial support is spotty, bumps along just above the poverty line. But they are joyful in their service in the inner city. . . .
• Number three child is also a son. At this time, he shows no inclination to serve Jesus. In fact, he's been to prison on a drugs charge. He has had several unbelievable business opportunities which, somehow, in every case, he has squandered. At this point in his life, he spends most of his time watching TV and playing video games. . . .

Question: Are you going to treat them all the same in your will? You know: being fair and all. . . .

Blue suggests--and I absolutely agree: no, you ought not to treat them all the equally! Love them all equally? Yes. Treat them all equally? No way!

But this is hard work.

I have determined that, God helping me, I will do that hard work in behalf of my children.

Well. And then there is this matter of a living will.

Our attorney, knowing of our Christian commitment, urged Sarita and me to sign some kind of--I'm not sure if it was a DNR/Do Not Resuscitate order, but--some kind of Living Will document that provided for less strenuous efforts than might otherwise be made. "After all," he said, "you know where you are going, and it is a Better Place."

I believe that. I don't believe This World is All There Is. So I have no strong motivation for clinging to this life beyond reason. Yet there is a purpose to life! There is a reason to keep living. At least, to some degree.

My brother, Pete, who was dead and yet is now alive: Pete says that, while he was dead, he [I'm not sure if he has said he met Jesus; but . . . ] . . . he saw that he has a strong hope for a much better/more beautiful "tomorrow"--after death. Yet he is glad he is alive. And I am glad he is alive. He has a reason for living on this earth today. He has things to do, promises to keep.

So how shall I write my living will?

I have some tough decisions ahead of me!

DNR (Do Not Resuscitate)

Our dad forwarded to all six of his children the following "Living Will." He said that, while he recognized its intended humorous side, he is considering taking to his attorney "and perhaps similarly changing my instructions":

MAXINE'S LIVING WILL

I, MAXINE, being of sound mind and body, do not wish to be kept alive indefinitely by artificial means. Under no circumstances should my fate be put in the hands of pinhead politicians who couldn't pass ninth-grade biology if their lives depended on it, nor lawyers/doctors interested in simply running up the bills.

If a reasonable amount of time passes and I fail to ask for at least one of the following:

Glass of wine
chocolate
Margarita
Cold Beer
Chicken fried
steak
creamy gravy
Mexican food
French fries
Pizza
ice cream
Sex

It should be presumed that I won't ever get better.

When such a determination is reached, I hereby instruct my appointed person and attending physicians to pull the plug, reel in the tubes and call it a day.

My next younger brother, who, about 10 years ago, was struck by a car and declared dead on the scene, but later revived, wrote the following:

-----Original Message-----
From: Pete
Sent: Sunday, November 12, 2006 5:39 AM
To: Dad, Holzmann-sibs
Subject: Re: DNR's (was: Maxine's New Living Will)

Actually this has a serious element, Dad.

We recently discovered, to our horror, that many MANY doctors have taken a very different view of "DNR" (Do Not Resuscitate) orders than we ever imagined.

What we always thought (and a very common perspective among friends):

* If you want reasonable steps to be taken in case of
    serious illness...

* But don't want "them" keeping your body going forever
    if something really bad happens...

* Then that's when you want a "DNR" order.

Today's reality:

* If a doctor has a "DNR" order on file for a patient...

* And the patient is very ill...

* Then many many doctors *explicitly* will say "don't
    treat that patient -- they want to die anyway"...

* Or, they may use "slow code" treatment, hospital-speak
    for acting slowly and deceptively in a way known to lead
    to death. [Case study: injecting life-sustaining meds
    into the mattress instead of the patient!]

* AND because the "DNR" order is legally binding and
    is in the hands of the doctor, loved ones who want to
    insist on proper care for the patient will have a REAL
    fight on their hands, to get the DNR order rescinded!

That's right: instead of

    "don't RESUSCITATE if they're gonna be a vegetable"

it's now

    "don't TREAT because they want to die anyway"

and

    "don't TREAT because they won't have a 'happy' life anyway."

(They're just "helping you along" a bit... with your "desired" lack of treatment you will soon succumb, and then not be resuscitated, and then be blissfully moving on and no longer taking up space on the planet... YECCCH!!!)

Literally, the professional argument is now over "quality of life" and "probability of recovery"... and many doctors simply decide that since the statistics say you will not enjoy life, your DNR says you prefer to die. This is vanishingly close to eugenics.

In light of this:

1) We're finding several (good!) facilities that explicitly say
    "if you come here for treatment, we will ignore any DNR
    order. After all, you are here to be treated, not to die."

2) We have torn up our DNR orders and instead have created proper
    (current) Medical Power Of Attorney documents.

3) Bottom line: ensure you have a loved one who understands,
    who will fight for your life as needed, and who will make the
    tough decisions... NOT a doctor you don't know!

Blessings,

Pete

PS: You might find these resources illuminating:

http://www.bcodp.org.uk/library/genetics/12dnr.pdf
[Case studies with disabled children (!)]

http://www.cumc.columbia.edu/news/review/archives/medrev_v5n2_0002.html
['Slow code' deceptive non-treatment of patients, and serious discussion of why it happens]

http://www.ama-assn.org/ama/pub/category/8390.html
[The AMA outlines a reasonable negotiation process, based on NOT having a DNR order]

http://www6.miami.edu/ethics/geriatrics_eol.html
[Overview of some topics. One that concerns me: there's a software package called "APACHE" that is increasingly used to make decisions on treat-or-not. Will we soon be told "sorry, the software says Pete won't make it, so we won't be taking him to the hospital"?!!]

As a one-in-a-million case of "non-CPR spontaneous recovery", this topic carries some import for me personally. ;)