Another area of medical treatment that your family and/or health care agents may need to make decisions about in a medical crisis is the use of antibiotics.  Because antibiotics are such powerful and common drugs, some health care planning documents, including the Washington State POLST form, ask for decision from patients about whether to accept or refuse all antibiotic treatment.  At Phinney Estate Law we find that this all or nothing approach isn't always the best way to think about the issue of antibiotics.

It is important to understand that when antibiotics are prescribed to treat infection the purpose can be both treatment or comfort care.  Think about your answers to the following questions:  Would you want a simple five day course of antibodics to treat a UTI, even if you had terminal cancer knowing that a UTI infection is unlikely to be fatal and can be very painful if untreated?  How about a six week IV antibiotic treatment for sepsis or pneumonia at time when you had such extreme dementia, knowing that either of these infections, common in those who are frail, would otherwise cause a fairly painless death in a relatively short period of time? 

The answer to whether you would want antibiotics in any given situation may depend on your quality of life absent the infection, whether the pain and symptoms of the infection can be otherwise managed, and whether withholding antibiotics is likely lead to a speedy death or merely additional prolonged illness. 

In our experience, agents are best able to make those choices if they have an understanding of what gives your life meaning and the picture treatment goals you would have in different states of health rather than a black and white thumbs up or down on antibiotics altogether.