2nd Opinion: Make end-of-life decisions today

"Dignity" and "responsibility" are the words that come to mind when I speak with families of hospital patients about advance-care planning. I can think of no better way to protect and sustain patients' dignity than providing the opportunity to make decisions regarding health care, especially when those choices extend past patients' ability to speak for themselves.

Too frequently, families express regret in failing to approach the issue of death and dying prior to the crisis in which they find themselves. Within my own immediate family, my father was forced to complete his directive to physicians and medical power of attorney days before the doctor scheduled an open-heart surgery to remove a tumor. Fortunately, my father survived the surgery and is doing well. He would be the first to tell you, however, he should have been praying and spending time with family and friends rather than meeting with his attorney. To my father's credit, all documents were in place when he entered surgery that day. As a family, we knew my father's wishes regarding life-sustaining treatment.

As a hospital chaplain who frequently has discussions with patients and families about advance-care planning and end-of-life issues, I can say the majority of people I meet are not legally prepared when they are admitted into a hospital. Whether it's the patient's fear of talking about such serious issues or the proverbial excuse "I've been meaning to …," few have taken the responsibility to express in a legal document how they want to be treated by a health care facility if they were diagnosed as terminally or irreversibly ill.

I could tell you account after dramatic account of families dividing over how to treat a loved one when medical efforts to sustain a meaningful life have reached their limits. However, a large majority of these true stories are basically the same. The patient fails to make wishes known and now can't speak for himself or herself. The family, often well-meaning, has conflicting opinions of the patient's desires for treatment. The crisis heightens, and so does the anxiety of the family. Name calling and accusations between family members occur, causing, at times, I imagine, irreparable damage to family relationships.

As a minister in a health care setting, my greatest wish for families is that they reconcile during these crisis moments. It's a beautiful sight to behold when families practice forgiveness and reconciliation when a loved one becomes terminally ill. It is equally as sad to see families torn apart because they disagree on what the individual, now silent, desired regarding treatment by a medical team. In these frequent cases, the individual's decision not to make a choice is after all, a choice. The other choice is to be prepared when the inevitable health care crisis occurs.

I encourage you to talk to the people to whom you are closest and let them know your thoughts about issues such as artificial life support and end-of-life care.

Also use this day to research and ask questions about advance directives and possibly have one completed before you are in a crisis situation. As people of faith, end-of-life care should not be a taboo topic but one spoken within the walls of our churches and in the intimate settings of our homes. The conversations may be difficult, but they also can be healing and bring families closer.

Make a choice, and let the future for which you are planning include providing guidance for your family regarding your health care wishes and ensuring that your own dignity be valued by your health care team.

Alan Wright is a chaplain at the Charles A. Sammons Cancer Center and Baylor University Medical Center in Dallas.