I’ve really been thinking about this a lot in preparation for the Advance Directives Party on April 16 (see calendar). I plan to talk in depth about it during the presentation. There’s been a lot of talk lately about how ineffective it is to write down your wishes about end-of-life medical care so that someone else can act on your behalf when you can no longer make decisions. And I think the problems are not in the document, but in the false assurance it may provide.

Here’s the issue: If you haven’t really talked about death with your family, then a document is not going to make up for that. If you think you can control what happens by listing things you want, then you haven’t really looked at what can happen at the end of your life. Sure, we’ve all thought about the “pull the plug” scenario if we suddenly become a “vegetable,” for lack of a better word. But most of the time, there’s not a plug to pull or there’s still a chance of improvement or recovery. Can our daughter or friend really make a decision to not put in a feeding tube if there’s even a 5% chance our brain may recover from injury?

That is the bigger question. In other words, are we “dooming someone to die,” a phrase I once heard in my family prior to a loved ones death? When are we “playing God?” When we extend life or when we let it go? This is the discussion we need to have with our family members. And writing down our thoughts may help. But it’s no guarantee.