Zombie has second thoughts on advance directives

Death Channels: Zombie copes with his/her uncle's death and the ramifications of an advance directive "Uncle Larry" had signed over a decade earlier, in a fit of depression when he'd first been diagnosed with HIV.

One night, I was alone with Larry in his room, while the night nurse was elsewhere in the building. He was due for another morphine dose in a few hours, so the previous dose was probably starting to wear off. For the first time in days, Larry stirred, and seemed to wake up. He made a faint moaning noise. I got up and leaned closer, and for the only time during the last month of his life, he spoke. It was just two raspy words: “Help me!”

I ran into the hallway and got the nurse, describing to her what had happened. Her response? “He must be in pain!” She came in and quickly gave him another dose of morphine. Before he faded back to sleep Larry made one last gesture: He shook his head, as if to say “No no no.” And then he went unconscious again. He never woke up after that, the nurses ensuring that he was drugged up at all times. He died three days later without saying another word or regaining consciousness.

What killed him? Well, the doctors would likely say he died of AIDS. But the direct cause of his death was, basically, starvation and dehaydration. Which, I later learned, is what actually kills many patients in hospice care, who often die from the withholding of nutrition rather than from the more slow-moving effects of their terminal illnesses.

....

In 1996, in a fit of depression, he signed agreements that his life not be “artificially” prolonged should he become severely ill. But I have this terrible nagging feeling that once he came face to face with the real possibility of death, he wanted to stay alive. I suspect that he struggled for a month to wake up so he could revoke the “Do Not Resuscitate” order. But partly because of his condition, and partly because of the drugs he was given, he was unable to speak or move.

When one is healthy and young it’s easy to causally say, “If I get old, just unplug me!” But the young and the healthy can’t imagine what it’s like to stare death in the face and know that no one will save you because you told them not to. The will to live is truly tested and often only becomes manifest when one is at the point of death. Can we trust the wisdom of our 40-year-old selves to know how we’ll feel when we’re about to die?

Furthermore — and in Larry’s case, more troubling — can we trust end-of-life instructions that were signed by someone who may or may not have been in his right mind?