La Plata Medical Society
  It's a very difficult time for all involved. Death comes to all of us but it can be made more difficult by family, friends or the doctor if we have not prepared for it.

Doctors are morally bound to fight death, but we believe we know when nothing more can be done and palliative care for comfort is all that can be offered.

Every physician and nurse has been in that difficult position where a relative, who might not have seen the patient for years, wants "everything done" to keep the patient alive. This might be from love, guilt or religious reasons. The patient should have the final decision, but most often is incapable of making it.

This is why it is important for you to attend the free Health Care My Way program at 6:30 p.m. Tuesday at the La Plata County Fairgrounds Extension Building. It is sponsored by Mercy Medical Center, and I highly recommend attending if you haven't made a living will.

Dr. Kip Boyd and Ellen Roberts will be the speakers, and I guarantee that you will learn the facts as they apply in Colorado.

A "medical durable power of attorney" is the first directive you should have. This names one or more people to speak to doctors about medical care decisions for the patient when the patient can't because of incapacitation. This might become necessary in terminal conditions, but is also needed after such events as a stroke or brain injury.

The living will is a good backup to the power of attorney. This guides others in decision-making for the patient regarding how many days life-sustaining treatment should be continued. Two doctors must certify in writing that the patient's condition is terminal and irreversible.

DNR (do not resuscitate) instructions may be included in the living will. These tell the nurses and medical personnel not to attempt CPR (cardiopulmonary resuscitation) when the heart has stopped. Otherwise these personnel are duty-bound to do mouth-to-mouth breathing and external heart compressions until a physician decides that the patient is dead.

It is very important to decide is if you want your organs donated if you are killed in an accident. Although this is on your driver's license, you must also let your family know because only one relative objecting can slow the process to the point that the organs are no longer useful.

This all might sound gruesome, but how do you want to spend your final days and hours?

Dr. John N. Withers is a practicing general surgeon in Durango.

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