It Always Seems Too Early, Until It’s Too Late

Article written by Monica Williams-Murphy, MD

The day that I finally asked my grandmother about her healthcare wishes was the day that she died. I consider this an epic failure on my part, for a host of reasons:

Number one: I’m a doctor! If anyone needs to be comfortable raising the question of advance directives, living wills, and what is wanted or not wanted in the setting of chronic or terminal illness it should be a doctor.

Number two: She had already verbally selected me to be her healthcare agent, but I had never taken the opportunity to explore and clarify her wishes before it became an emergency situation.

Number three: It had always seemed to be too early to have “the conversation,” but in the end it was nearly too late. I had fallen prey to the same kind of avoidance and procrastination that besets nearly all Americans when it comes to critical healthcare planning.

DON’T BE LIKE ME! Know the healthcare wishes of your loved ones and set your own affairs in order. Hopefully, you can learn from my mistakes before they become your own.

Fortunately, National Healthcare Decisions Day is just around the corner, on April 16. One of the most important healthcare decisions you can make is selecting and educating your healthcare agent- someone who can speak on your behalf if you become unable to speak for yourself. Here are some pointers for doing it right:

A. Think about the following topics when choosing your healthcare agent(s):

  • Do they have any medical knowledge?
  • Are they willing to put your needs and desires before their own?
  • Do you trust them?
  • Does your extended family trust them?
  • Do they have good leadership and decision-making skills?
  • Would you trust them to take care of someone you love?

B. I recommend that you discuss the following topics with your selected healthcare agent(s):

  • Outline your present level of health and quality of life. Consider using this free tool as a guide.
  • Discuss your feelings about death, dying, and illness.
  • What level of physical independence is important to you?
  • What level of mental activity is important to you?

C. With your healthcare agent(s), discuss whether there is a time or a quality of life beyond which you would NOT want any of the following (Consider using this free tool as a guide):

  • Surgical procedures
  • Dialysis for kidney failure
  • Feeding tube for artificial nutrition
  • Blood transfusions
  • Transfer to an acute care hospital
  • Hydration with IVs
  • Antibiotic treatment
  • CPR or artificial life support
    If you have already come to a decision to decline CPR or artificial life support measures and desire a natural death (with comfort measures), talk to your doctor about this decision and he or she will complete the necessary paperwork to honor this wish.

Remember, such decisions can never be made too early, but they can always be made too late.

Click here for a free Advance Directive.

Dr. Monica Williams-MurphyDr. Monica Williams-Murphy is an Emergency Physician and Medical Director for Advance Care Planning and End of Life Education at Huntsville Hospital. She serves as a resource and speaker for Madison County groups who want to know more about preparing for peace at the end of life. She can be reached at This email address is being protected from spambots. You need JavaScript enabled to view it..

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