The-Tibetan-Book-of-Living-and-Dying

380 APPENDIX TWO
essentially dead patient is pumped full of drugs, stabbed with dozens of
needles, and jolted with electric shocks. Our dying moments are closely
documented by heart rate, levels of oxygen in the blood, brain wave readings,
and so forth. Finally, when the last doctor has had enough, this technohysteria
comes to an end, 2
You may not wish to have life-support mechanisms or be resuscitated,
and you may want to be left undisturbed for some time after
clinical death. How can you ensure that your wishes for the kind of
peaceful environment recommended by the masters for dying will be
respected?
Even if you state your wishes about wanting or refusing certain
kinds of treatment in the hospital, your requests may not be
respected. If your next of kin does not agree with your wishes, he or
she may ask for particular procedures to be started even while you
are still conscious and able to talk. Unfortunately, it is not uncommon
for doctors to comply with family's wishes rather than those of the
dying person. Of course the best way to have some control over
your medical care when you are dying is to die at home.
In some parts of the world, documents known as Living Wills
exist, through which you can state your desires for treatment in case
the time comes when you can no longer make decisions for your
own future. These are a sensible precaution, and help doctors if they
are faced with a dilemma. However, they are not legally binding, and
cannot anticipate the complexities of your illness. In the United States
you can draw up what is called a "Durable Power of Attorney for
Health Care" with a lawyer. This is the most effective way to state
your choices and ensures, as far as possible, that they will be
respected. In it you name an agent, a legal spokesperson who understands
your attitudes and wishes, who can respond to the special circumstances
of your illness, and who can make crucial decisions on
your behalf.
My advice (as I indicated in Chapter 11, "Heart Advice on Helping
the Dying") is to find out whether or not your doctor is comfortable
honoring your wishes, especially if you want to have life-support
measures withdrawn when you are dying, and you do not wish to
be resuscitated if your heart stops. Make sure that your doctor
informs the hospital staff and has your wishes written onto your
chart. Discuss the issue of your dying with your relatives. Ask your
family or friends to request the staff to disconnect any monitors and
IV lines once the process of dying has begun, and to move you from
an intensive care unit into a private room if feasible. Explore ways in
which the atmosphere around you can be made as quiet, peaceful,
and as free from panic as possible.