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


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measures withdrawn when you are dying, and you do not wish to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.

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