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Published - Tuesday, July 08, 2008

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Terry Rindfleisch: Advance directives: Don’t leave your family guessing


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The woman who was caught up in a right-to-die case in La Crosse courts last year died recently at Gundersen Lutheran Medical Center.

From what I have gathered, Sally’s (not her real name) condition had worsened recently, but she continued to receive medical treatment before she died. Lawyers and Gundersen Lutheran officials said they could not comment because Sally’s guardian refused them permission to talk about the case.
Sally’s guardian had gone to court in July 2007 to withdraw the La Crosse woman’s life-sustaining treatment. Sally, in her 50s, was being kept alive at Gundersen Lutheran by continuous sedation and a feeding tube. She had suffered seven strokes since 1995, and the most recent caused a violent dementia.

Sally refused to eat or drink, and she had torn out feeding tubes in the past, so she needed to be sedated to continue feeding her, her doctors said. Her family wanted Gundersen Lutheran to cease life-sustaining treatment.

A guardian has no authority in Wisconsin to make that kind of treatment — or lack of treatment — decision unless the patient is in a persistent vegetative state or has expressed wishes through a conversation or advance directive.

In this case, Sally was not in a persistent vegetative state and didn’t have an advance directive. But the guardian’s attorney said Sally’s medicated condition was “functionally equivalent” to a persistent vegetative state. When Sally was competent, her actions showed she placed a high value on her personal dignity, the attorney said.

The lawyers argued over whether the court case should be public or private. A judge decided the public had a right to know about the case.

In the end, the guardian’s attorney withdrew the request to stop life-sustaining treatment. The attorney said he had received a medical opinion about Sally recently “that convinced us not to proceed at this time.”

We can talk over the tens of thousands of dollars spent to keep Sally alive and her pain and suffering — and trying to follow or seek to change the law. But the point is all this could have been avoided if Sally had written an advance directive telling her family of her wishes.

Everyone should consider a power of attorney for health care.

Make it clear to family when you want to be kept alive by medical treatment. Don’t leave your family members guessing.

Have a conversation with your family about your wishes. People need to talk with their families about whether they want to prolong life or receive only comfort care if near death or struck by sudden, devastating illness or injury.

Appoint a power of attorney for health care, someone who truly is an advocate and can carry out your wishes.

Do it for Sally and your family.

Terry Rindfleisch can be reached at (608) 791-8227 or trindfleisch@lacrossetribune.com.
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