press-citizen.com | Staff Editorials
Saturday, August 19, 2006
Our View - Make sure your family doesn't have to second guess your wishes
All competent adults need to provide advanced directives about their health care choices, or they might not receive the care they desire when facing a health crisis. This is especially true for anyone whose beliefs about what constitutes acceptable medical practice are out of the mainstream.
During last year's Terri Schiavo case, we saw a Florida family torn apart for more than a decade as Schiavo's husband argued she wouldn't want to live in a vegetative state and Schiavo's parents argued that she would. Without ironclad proof of a patient's wishes, spouses and parents can battle passionately, righteously and pyrrhically to defend what's in the patient's best interest.
In case we needed an example closer to home, we now have one with Tawnya Brooke Nissen, a Clinton woman who is in a medically induced coma at University Hospitals ("Parents of comatose woman win dispute," Aug. 17). Her doctor testified that if her condition worsens, she could require a blood transfusion. Her husband, Chris Nissen, has told physicians that he and Tawnya are Jehovah's Witness and would not consent to a transfusion because of the faith's beliefs in the sanctity of blood. Tawnya herself may not be able to communicate her treatment wishes for up to six months.
Tawnya's father, Richard Reid, and her sister, Amanda Bingham, testified that Tawnya had told them she would accept a blood transfusion if it meant the difference between life and death either for herself or for her 5-year-old son.
Again, a spouse and a parent from different religious perspectives argue over what constitutes acceptable care. In this case, the court ruled that, without assurance of the patient's wishes, it should err on the side of providing care. On Wednesday, Johnson County District Court Judge Marsha Beckelman appointed Tawnya's father as her "limited guardian" and ruled that Chris Nissen may be present at meetings with hospital personnel to discuss her medical condition and treatment.
Iowa law sets up a process that allows for the withholding or withdrawing of life-sustaining procedures if a doctor agrees with the person who has been appointed to make decisions for the individual. If there is no one appointed, the law basically sets up a hierarchy of individuals who can consult and agree with a physician: the appointed proxy, the incapacitated person's guardian, the person's spouse, a majority of the person's adult children, the person's parents and then the person's adult siblings.
But this case shows that, without clear directives, the hierarchy can be challenged. An adult's parents and siblings can challenge the decisions of his or her spouse. No one wins when these battles end up in court.
Everyone needs to provide these directives because there are a variety of health care choices to make, and today's legal climate requires that these be made known in a specific way. The case of Tawnya Nissen is a religious one, but the issue is not about religion. It is about your legal right to make the best health care choice for yourself and those in your care.
To make an advanced health care directive, you have to explain in writing your wishes concerning what procedures you would consent to withhold or to have withdrawn. Then you must have the written document witnessed and signed. There is a sample form in Chapter 144 Section A.3 of the Iowa Code, but the document can be tailored to reflect your specific wishes.
Article Referenced:
DesMoinesRegister.com
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Our View - Make sure your family doesn't have to second guess your wishes
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