Advance Directive - artificial feeding and ventilation

[EnquiringMindsWantToKnow]

Hello

I'm a healthy 43 year old. I'm permanently single with no children and no immediate family. Non religious.

As part of my making a will and power of attorney, my solicitor has suggested I consider making an Advance Directive.

I expressed that I support Dignity in Dying and my intention to go to Switzerland if they haven't changed the law here when my time comes.

He needs to know whether I would ever consent to:

• artificial feeding
• being put on a ventilator

ChatGPT suggests I should consent as long as I'd have a reasonable quality of life afterwards and it's only a short term illness eg an infection or pneumonia.

What do you guys think? Thanks.

Basically - are they really horrible for the patient?!

Ventilation is very invasive and would be very uncomfortable if you were conscious. However, if a patient needs ventilation, they are normally sedated so they can tolerate the treatment. Ventilation is life-saving and used for the shortest time possible. What you might want to consider is whether you would want a tracheostomy in the event that you couldn't be successfully weaned from a ventilator.

Artificial feeding generally involves a small tube passing from your nose to your stomach. There are other methods, but that's the most common. Again, it's used for the shortest time possible. It isn't hugely uncomfortable for most people because the tube is very small.

In over 20 years as a doctor I’ve still not seen an advanced directive that was useful for the context in which I was meeting the patient (usually in icu or coming for an anaesthetic). Far better than getting a solicitor to help write one would be to speak to a doctor. Using your example of being ventilated, It’s worth remembering that many operations involve ‘being on a ventilator’ at some point so the paperwork needs to be very clear if it’s not just going to confuse things if you end up coming in with something like a broken leg or appendicitis.

there may be some value in using a ReSpect form/something similar which documents in slightly fluffier terms what your priorities are rather than referring to specific medical interventions and gives HCPs a little more scope to interpret things in that specific context. The respect form also wouldn’t cost you money. (It’s easily googleable if you’re interested so you can see the sort of stuff bit includes)

perhaps the main exception to this though is if you have very strong feelings about blood transfusions (probably not if you don’t have a strong faith based reason to avoid) - for some people that really does feel like an important document to have sorted out and can be very helpful for HCPs to know about.

Similar thoughts to the above, I've never seen them as useful.
I see them moreso as a devise to stop you sueing the hospital.
I'm my own frame of reference, I've refused to convince a family member to sign, as I've advised them a doctor should be able to make a good decision in the moment. Apparently that's a very unpopular viewpoint

It might be worth knowing that doctors are required to treat in the patient's best interests, too. If there is no realistic likelihood that the patient will recover, they won't provide intensive care. They really do treat each patient individually.

Thanks all, I appreciate it.

I wish i WAS a doctor and could make more informed decisions.