Even when you are prepared and ready for any eventuality in the care of a family member, it is extremely difficult and emotional when you get the news that one of your loved ones will not get better. There are a hundred conflicting emotions and realities and ethics that factor into the decision making around their care. You may want more time with your loved one, and want to keep them comfortable. You may be hoping against hope that there will be some last-minute miracle cure, while also knowing that isn’t likely. Finding the moment when curative care transforms into palliative care is the acceptance of a sad reality.
Through all this, the decisions you and your family make may all be life-and-death. These kinds of decisions have deep ethical ramifications—whether its deciding whether or not to continue life support, or planning a reunion between your father and his estranged brother. These situations involve much deeper ethical considerations than the ones we usually confront. This is why they often feel overwhelming in the moment. While no article can successfully create an ethics guide that encompasses your family’s values, this guide has some ideas to consider.
Your Loved One’s Wishes
The most important thing to center when you’re making decisions for a loved one’s care is their own wishes. Medical autonomy (the right to have control over your own medical care) is a valuable right. When a family member gives you power of attorney over their medical care, they are entrusting you with a huge part of their medical care. With that trust comes the responsibility to understand your loved one’s wishes for quality of life. A good way to start with this is a conversation.
Understanding the baseline quality of life your loved one hopes to maintain is a good place to start. Would your father be happy sitting on the couch watching football, or would he be miserable with limited mobility? Does your mother want to live to your wedding, or is she more concerned with managing her pain? Understanding the answers to these questions is a good guide to making decisions.
It is worthwhile to continue having difficult conversations with your loved one throughout their treatment. Check in regularly, and be sure to listen to what they’re saying. It can be difficult to hear that a loved one is ready to stop aggressive curative care, but ensuring they have a beautiful end-of-life means the time you have left together can be meaningful.
You may not be able to have these conversations in every situation, but when possible, they can give you a good roadmap to move forward.
Other Things to Consider
You may also want to consider things outside your loved ones care as you approach their end-of-life. Organ donation can be a lovely way to have a sad situation make a positive impact in someone else’s life. You can also consider environmentally friendly funerals and encouraging charity donations in your loved one’s name.
In short, having conversations about your loved ones wishes both before and during their medical care can make navigating the ethics of end-of-life care much, much easier.