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Disability Planning Treatment Choices: Medical Interventions

9/28/2011

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In past posts on this blog we have written about resuscitation as a decision that must be made for other is cases of disability.  There are also a host of other choices about medical interventions that must be made. 

Medical Intervention is a broad category but the some of the most commonly used interventions are Intubation,Tracheotomy, Surgery, Dialysis, Chemotherapy, Radiation, Biopsy, MRI, and Colonoscopy. 


Intubation and tracheotomy are used primarily to create artificial air ways.  Failure to use them often leads to rapid death.  Both procedures involve a painful recovery.  Both may last either a short time or for an extended period depending on the reason for the airways blockage.

Surgery, dialysis, chemotherapy, and radiation are primarily treatment options but may also be used even where recovery is not possible to extend life and to relieve symptoms.  All involve some pain, discomfort and a recovery period.  With the exception of surgery all are ongoing and can be tried for a period and then ended.  For example, you might leave instructions to try medical interventions for a period of 30 days and then terminate if there is no sign of recovery unless intervention is also serving a pain relief function.  In the alternative you might request that where there is no meaningful hope of recovery your would choose comfort care only which might include such interventions if the primary purpose was to relieve pain or other symptoms.

Biopsy, MRI, and colonoscopy are all diagnostic tools that may be necessary to allow treatment. None is pleasant but pain and recovery, if any, is usually minor.  However, some people may feel that even the mild trauma and pain is something that they wish to avoid if they are in a condition such as advanced dementia where they would not choose to treat any condition such as cancer that might be discovered.

In making decisions about such interventions it may be helpful to talk to a doctor or to a friend or loved one who has gone through the experience.  This is also an area where it may make sense to have an ongoing directive that addresses broad categories or gives general instructions about how to make choices but to consider updating your instructions to be more specific if you get a diagnosis that is likely to bring your  directive into effect when you will have a better sense of what specific interventions might be needed in h. 

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    This Blog is written by Seattle Attorneys Jamie Clausen & Michael Ballnik.
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