The Last Chapter - End of Life Decisions
Living Wills and Advance Directives for Pancreatic Cancer Patients
Living wills can provide you and your family with peace of mind.
By Diana Rodriguez
Medically Reviewed by Lindsey Marcellin, MD, MPH
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All adults, healthy or not, should have living wills and other advance directives that tell your doctors and loved ones how far you want them to go to keep you alive. If you have a serious health problem like pancreatic cancer, it's especially important to create a living will.
For people with pancreatic cancer, having these documents in place can relieve the stress and burden on your family. If you have a living will, both doctors and family members understand your wishes, and won't need to make decisions for you when you are unable to make them for yourself.
Pancreatic Cancer: Advance Directives and Living Wills
Advance directives, such as living wills, can tell your medical team how and when you would want your life to be prolonged. There are three main advance directives pancreatic cancer patients should consider:
- Living wills.This is a legal document that describes how you do or do not want your life to be prolonged if you are seriously ill, near death, and unable to speak for yourself. Living wills should state whether you ever wish to be put on a ventilator (breathing machine), have a feeding tube, and other procedures that may prolong your life. An attorney must create living wills.
- Do not resuscitate (DNR) order.A DNR states that you do not wish to be resuscitated (brought back to life with chest compressions and rescue breathing) if your heart should stop, or if your breathing should stop. This is an order noted in your medical records by your doctor, and does not need to be drawn up by an attorney.
- Power of attorney.People with pancreatic cancer may want to assign a medical or durable power of attorney that allows someone else to make decisions about health care in the event that they are not able to make those decisions themselves. Many people choose their spouse, a child, or a sibling to hold their power of attorney.
End-of-Life Issues in Pancreatic Cancer: An Expert Perspective
"A health care power of attorney authorizes someone to act from the moment a power of attorney is signed forward," says Lee Richardson, an elder law attorney practicing in Louisville, Ky. "[It] would authorize somebody to consent to surgeries and procedures that can impact quality of life."
"A living will only applies if the patient's physician and one other physician both certify that the patient has a terminal condition and that death is expected within a relatively short period of time," says Richardson, speaking of the particular statute in Kentucky. The exact rules may vary by state, but are similar across the country.
"Most medical professionals assume that to mean within a few weeks. A living will can also apply if someone is in a coma and there is no reasonable medical likelihood that they are going to come out of that coma," notes Richardson.
There are many ways to be kept alive today. But when making such an important decision, quality of life must be considered. Extreme measures may keep your heart beating but they won't necessarily offer a life you wish to have.
"Most people … want to be able to die a natural death when the time has come," says Richardson.
If you've been diagnosed with pancreatic cancer, it's important to stay as positive as possible, and do everything that you can to beat the disease. But it's also very important to have plans in place in the event that you are unsuccessful in your battle.
Thinking about these end-of-life issues doesn't mean that you're giving up — it just means that you are protecting yourself and your family. Having a living will and other advance directives means that you are making a decision about what should happen if the time comes that treatments are unsuccessful, and you are unable to communicate your wishes. Knowing what your wishes would be in this situation can relieve your family of a great deal of uncertainty and can make a difficult time a little bit easier for them.
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