Myths and Facts About End-of-Life Care

No one looks forward to a time when he or she is unable to express desires for getting or refusing medical care, or to when they must do so on behalf of someone else. Having a health-care power of attorney and a living will helps to spell out your wishes, but according to a recent issue of Healthbeat, a newsletter from the Harvard School of Medicine, there’s a lot of misinformation about this delicate and difficult time.

In an article called “Commonly held myths about end-of-life issues,” Harvard set out to correct the record, and to reinforce the reality that these documents don’t deprive you of your rights; they ensure that you get the treatment you would request if you could speak for yourself.

Here are common myths, and their corresponding truths.

Myth: More care is always better.

Truth: Sometimes more care prolongs the dying process, and degrades the quality and/or the comfort of the life that remains. It’s important to know what interventions are truly important, and often they are unknowable in advance. The health-care team should be objective, compassionate advisors who welcome your questions.

Myth: Refusing life support invalidates your life insurance because you’re committing suicide.

Truth: Refusing life support is not committing suicide. The cause of death is the underlying medical problem, not the decision not to prolong it.

Myth: If medical treatment is started, it cannot be stopped.

Truth: Not starting a medical treatment and stopping a treatment are the same in the eyes of the law. So you or the person who has the right to make decisions for you may approve a treatment to see if it helps without fear that you won’t be able to change your mind later. But be aware that stopping treatment can be emotionally more difficult than never starting it.

Myth: If you refuse life-extending treatment, you are refusing all treatment.

Truth: You may refuse certain treatments and still expect to receive other care you want or need, especially for management of pain and symptoms that’s sometimes called intensive comfort care.

Myth: Stopping or refusing artificial nutrition and hydration causes pain for someone who is dying.

Truth: Unlike withholding food or water from a healthy person, declining artificial means of feeding or intravenous hydration for a dying person does not cause him or her pain.

For more information about how and why to enlist someone as your health-care agent, see Patrick’s newsletter, “Who Speaks for Your When You Can’t Talk to the Doctor?”

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