The Rogers family Thanksgivings are epic. Mom and Dad’s adult children return to the nest with their own families for the festivities, which include a fiercely competitive flag football game, and conclude with a feast that will take them all weekend to recover. But this year will be remembered for all the wrong reasons.
The game was tied and there was only enough time for one more play. Mom and Dad watched their five kids, with their three spouses and two new significant others, and 13 grandkids lined up, ready for the snap. Their middle son, Aaron, takes the snap. As he steps back to survey the field, he trips over a rogue cornhole beanbag and falls to the ground. His opponents laugh while his team implores him to get back up. Dad throws his hands up in the air with an “I told you so,” reminding everyone he said they should clear the field before they played. Meanwhile, Aaron remains motionless.
Suddenly, everyone realizes Aaron isn’t moving. Some think he’s joking around, but not his wife, Carly. She runs to him and screams when she realizes she can’t wake him.
Aaron is rushed to the hospital. He’s in the emergency room with the family anxiously sitting, pacing, and praying in the waiting room.
A doctor emerges to tell the family Aaron hit his head and suffered a subdermal hematoma or bleeding on the brain. They have two choices — wait and see if the bleeding and swelling subsides, or drill a hole to release the pressure. The doctor needs an answer right now, but who makes the decision and how do they decide?
The surgeon turns to Carly. She’s a deer in headlights. Carly and Aaron are in their 40s, and like just about everyone else their age, they never talked about this kind of stuff, let alone planned for it.
Mom says she knows Aaron would want to give it time, but Dad says Rogers men are strong and the doctor should drill away. Brothers and sisters recall a lifetime of conversations with Aaron, trying to guess what their brother would want.
Everyone is scared. Some are crying, others yelling, a few crying and yelling. Carly kneels down to hug her two kids close to her, hoping to escape from this nightmare swirling around her.
Carly can’t escape. A tap on her shoulder from the doctor brings her back to reality. He then asks her, “Does your husband have an advance health care directive?”
What is an Advance Health Care Directive (AHCD)?
California provides a statutory AHCD in Probate Code Section 4701 where it states, “You have the right to give instructions about your own health care. You also have the right to name someone else to make health care decisions for you. This form lets you do either or both of these things. It also lets you express your wishes regarding donation of organs and the designation of your primary physician.”
It comes complete with instructions, can be filled out by any competent person over the age of 18, and just needs the signatures of two witnesses (who cannot be related to you) or a notary to be enforceable. You can find the statutory version and others on our website: https://bier-law.com/resources/advance-healthcare-directives/
So, had Aaron taken a few minutes to fill out and execute an AHCD, would the Rogers’ family problems be solved? Not exactly.
You have the right to give instructions about your own health care.
As the statute says, you have the right to give instructions, and the AHCD provides some options for you to choose from. However, they are very basic and do not help you contemplate the myriad of circumstances one may find oneself in, especially considering all that modern medicine has to offer.
The most basic (and most important) decision you are asked to make on the AHCD is about your end-of-life decisions. Do you choose to prolong life or not prolong life — also known as the don’t-pull-the-plug or pull-the plug decision for those who typically use humor to deal with these difficult topics.
For Aaron’s family, no one knows what Aaron would choose because not only did he not have an AHCD, but he never talked about it with his loved ones. Had he and Carly, he and his parents and siblings, talked about what types of treatments he would or would not want, what sort of quality of life he would need to make life worth living with some discomfort and other challenges, and whether he would want to take risks for a potential recovery versus leaving things to fate, a deity, etc., at least then the family would have some direction and be able to move forward on a united front.
You also have the right to name someone else to make health care decisions for you.
An AHCD is a document that can speak for your when you can no longer speak for yourself, but its real power lies in its ability to allow you to choose someone to speak for you, to weigh the options, and make decisions as you would have had you been able to do so.
While it may seem simple to pick a person to be your Agent (that’s the technical term), a lot more should go into this decision. Most of my clients choose their spouse if they are married and a parent or sibling if not married. But just because someone is your best friend or knows you better than anyone else, they are not necessarily the best choice. Will they be able to stand up for your wishes and respect your decisions even if they don’t agree with them? What if others disagree, or perhaps even doctors think you’re being irrational?
Typically, Aaron would have chosen Carly. But Carly is far more practical than Aaron, and panics in emergencies. Mom leans towards giving control to a higher power while Dad thinks his son is invincible, and both think they know better than anyone else, including Aaron. Aaron’s sister, June, is a pediatrician, but she is constantly annoyed at family members who don’t take her medical advice. So, who should Aaron choose to make sure his wishes are respected? How about his brother, Fred, who is a compassionate listener (and cardigan-trendsetter) who always had his back, even if Aaron was in the wrong?
Perhaps the most important part of end-of-life and medical emergency planning is The Conversation. For most people, it’s hard to think about death and disability, let alone talk about it. But how can you make sure your wishes are known, respected, and carried out without telling people, the people closest to you, what you want and don’t want? You can’t!
You will never make a more intimate, personal decision than your end-of-life decision and that’s why you should share the process of learning, reflecting, and deciding with the people you love, respect, and care about. These conversations, while initially awkward, will bring families closer together than ever before, but how do you start them?
We work with the non-profit The Conversation Project to help you start the conversation – actually, we hope this will be the start of life-long conversations because we change, our health changes, and modern medicine changes. As proud Champions of The Conversation Project, we lead presentations that walk you through our Conversation Starter Guide (which you can download here https://bier-law.com/conversation-starter-guide/) and help you and your family deal, once and for all, with this once taboo topic.
A Happier Ending
When the doctor emerged from the ER and approached the Rogers family, Carly was ready, standing strong with the rest of the family by her side. She had provided a copy of Aaron’s AHCD to the hospital staff and the doctor knew right away who Aaron’s agent was, his wife.
Aaron told his wife and family during their many in-in depth conversations about the reality of life, that he wanted to do everything he could to be there for his wife and kids. If modern medicine could intervene and provide him with a chance to survive and live a meaningful, impactful life, then go for it. As long as his mind works and he can express himself, he can be a positive force for his kids.
They sent the surgeon back in to save Aaron’s life. The Rogers family wrapped themselves in the warm embrace of each other’s loving arms in what looked like a giant huddle in the middle of the waiting room. There was no arguing and no confusion. The family was on the same page, a page written by Aaron, and no matter what happened next, they moved forward together with love and hope, knowing that their husband, son, brother and uncle was at peace because although he couldn’t speak for himself, he was still in total control of his medical decisions.
* This is a work of fiction. Names, characters, business, events, and incidents are the products of the author’s imagination. Any resemblance to actual persons, living or dead, or actual events is purely coincidental and is not related to the premature elimination from an office football pool due to the poor play of any particular individual.