End-of-life decisions, cherishing life itself

I listened with fascination to the news story this week about a nurse at a retirement home in California who called 911 on behalf of a resident who’d collapsed. While waiting for the medics, the nurse refused, even at the behest of the 911 operator, to perform CPR on the dying woman. The elderly lady did, in fact, pass away later.

The retirement home defended the nurse’s actions. Administrators argued, according to news reports, that their standard protocol of not administering CPR was correctly followed and that the policy was known to its residents.

A shocking story to others, but it wasn’t to me. That’s because just weeks ago I had a conversation with my own elderly father’s caregivers about whether we (the children who are his legal health-care executors) wanted him to be given CPR in case of an emergency. His caregivers are very kind. They just wanted clarity on whether to administer CPR if called for or, presumably, to be willing to let him pass away. It’s a routine question they have to ask. That did shock me.

But now I know this question is faced countless times a day in our culture.

Recently, such end-of-life questions got even more personal for me. In January, I had an involved open-brain surgery to “clip” a menacing and potentially deadly cerebral aneurysm we’d found, amazingly, before it bled. (It was discovered just before my wedding. In other words, my dear husband started living the “in sickness” part of the equation before even marrying me. But that’s another column!)

There was a chance that I could die or become incapacitated just from the surgery alone. So I revisited my will and documents about end-of-life decisions.

I found that “living wills,” a version of which I’d hastily put in place after my divorce years ago (and which, it seems, every medical facility practically demands that you have), now generally shocked me, too. It seemed to me that they are largely written for those who crave control and who think they can preside over their own demise. But one can rarely dictate these things. If A happens, do B; if C happens, do E, but do not do F. And so on.

Really. Who dies like that?

I opted for a durable medical power of attorney only, in which a trusted person is allowed to make necessary health-care decisions if I can’t. Actually, many people have both a living will and a medical power of attorney, precisely because often the living will isn’t relevant at all to the actual circumstances surrounding their death. I named my husband as executor. I inserted language about my philosophy of cherishing life, yet noted that extraordinary intervention to sustain life when death is likely imminent can be an attempt to idolize it, and I don’t want that, either. And yes, I outlined some things, like wanting nutrition and water to be administered regardless of the “quality of life” I’m experiencing and even if technology has to be used to administer them. There were other specifics. I worked off a template for writing it, one that spoke to my values.

I think it’s a good thing to express such desires, and I’m sure those who love me will try to meet them as I would theirs. But come on. In the end – literally – we can’t really control our ending. Knowing that is part of the wonder of life.

Well, I believe the elderly woman in California should have had basic CPR administered. Even when we don’t feel like it, I think we have a responsibility to take reasonable measures to try to support life, whether our own or another’s. I want my dad to receive CPR if he collapses, and I have made that clear. And I am so grateful that I made it through surgery without anyone needing to reference the documents I recently created.

But the fact remains that I have about as much say over my death as I did my birth. Neither a living will nor a durable medical power of attorney – nor anything else – can change that. Ultimately, I need to trust God, and trust others, and decide to rightly cherish life and its unfolding mystery without idolizing it. Sadly, in our culture today, it seems to me such an understanding can be, well, pretty shocking.

Betsy Hart’s latest book, “From The Hart: A Collection of Favorite Columns on Love, Loss, Marriage (and Other Extreme Sports),” has just been revised. Email hartmailbox-mycolumn@yahoo.com.