New Frontier in Advance Directives
(also know as a Medical Power of Attorney) 

The headline reads:  “Treading into ethically and legally uncertain territory, a New York end-of-life agency has approved a new document that lets people stipulate in advance that they don’t want food or water if they develop severe dementia.”  We all know that dementia is a terminal illness, but in those states that allows for “aid in dying” dementia is not a covered condition.  The document offers two options:  1.  “comfort feeding”  providing oral food and water if a patient appears to enjoy and allows it or 2.  Cessation of all assisted eating and drinking, even if the patient seems willing to accept it. The reasoning for the appropriateness of such a document is that they patient can make this decision soundly before the ravages of this disease deprives them of the ability to make such a decision.  Would a facility or a doctor honor such a request—the withdrawal of basic care to such a vulnerable population? Canadian courts have ruled that such  feeding is basic care that can’t be withdrawn.  Certainly this issue will end up in the Courts here in the United States?  Something to think about?  Where do you stand on this issue?

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                                                                                                            --   Nancy Nawrocki