How do you advise Mrs. Smith? Do you recommend a DPAHC for her? Would completing a third-generation directive more completely assure that her wishes be honored? Should both children be named as her surrogate decision maker? Are there other legal documents that might better address her concerns?
Mary Smith is a 67-year-old, newly widowed, individual who has recently been diagnosed with congestive heart failure and advanced chronic pulmonary obstructive disease. After the early death of her husband, she was employed for several years as a secretary for a corporate lawyer.
Though she was a "heavy" smoker for several years, she had not smoked in the past three years. She has two adult children, both very concerned about their mother's health. Both children are married, have teenage children, and live within 100 miles of Mrs. Smith.
Mrs. Smith expresses concern about her future health care needs, primarily when she is not able to make decisions for herself. She tells you that she does not want to be kept alive on machines and desires to die as "naturally and painlessly" as possible. When asked, she tells you that she has discussed none of her desires or wishes with her family members and wonders how to best open such discussions. She is afraid that her family will not abide by her wishes for a "natural death." She asks your advice in assuring that her final desires will be honored "when the time comes."
How do you advise Mrs. Smith? Do you recommend a DPAHC for her? Would completing a third-generation directive more completely assure that her wishes be honored? Should both children be named as her surrogate decision maker? Are there other legal documents that might better address her concerns?
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