Wishes

This week in journal club we discussed several articles about Medical Ethics Dilemmas.

47 year old woman in the Emergency Center from a motor vehicle accident. Her only hope is blood transfusion, but she is a Jehovah's Witness and so refuses the transfusion. Does the doctor give her the transfusion against her will or honor her religious believes and allow her to die?

An elderly woman transported to the Emergency Center with severe respiratory distress. She has severe, end-stage lung disease and has clearly expressed to her family, friends and physicians that she does not want her life artificially prolonged. However, her loving husband and family cannot bear the thought of her death, and beg that "everything be done" to preserve her life. Her medical condition is precarious and only the placement of an "endotracheal" (breathing) tube and attachment to a respirator will allow her to survive. What should the doctor do?

While these are thought-provoking and conversation-generating ethical dilemmas, the real meaning comes in how this impact my life - your life - our lives. What are my wishes, I ask myself?

If I am in a trauma situation and I am unable to speak for myself, who do I want to speak on my behalf? Do I want to be resuscitated? Would I want to be on a breathing machine? What about tube feeding, if I am incapacitated for such a time that I need nourishment - would I want that?

I see this in the hospital time and time again - families anguishing about what their loved one would want them to do. So, have I talked to my family about my wishes?

Have you?