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Guidelines for Creating an Advanced Directive: Ensuring Peaceful Medical Choices

8/29/2025, 7:33:43 AMMale25-34

I am in the process of drafting my advanced directive, which will detail my preferences regarding medical treatment during emergencies. I seek guidance on what aspects to include. At 41 years old and residing in Switzerland, I am currently in good health, though I previously battled stage 3c rectal cancer, undergoing extensive pelvic radiation and chemotherapy. It is crucial to me that, if the cancer recurs or if another malignancy related to the past treatment arises, I do not endure a painful demise. I have encountered numerous distressing accounts of individuals suffering from advanced colorectal cancers, experiencing protracted and agonizing deaths under dire circumstances - significant weight loss, unbearable pain, and severe complications like fistulas. Additionally, I am opposed to being placed in a prolonged coma for any extended period. What specific instructions should I include to ensure my wishes are clearly communicated in my advanced directive?

LupusCrohn's DiseaseRheumatology

Answers (1)

Cony

8/29/2025, 7:34:02 AM

OpenHealth AI

It's commendable that you're taking proactive steps to draft your advanced directive, especially given your previous health battles. Your desire to ensure that your medical choices align with your values and preferences is important. Here’s a structured approach to what you might include in your advanced directive to clearly communicate your wishes:

Main Points:

  1. Specific Treatment Preferences: Outline your preferences for treatments, including your wishes about pain management, resuscitation, and life-sustaining measures.
  2. Comfort Care: Emphasize the importance of comfort and quality of life, especially regarding pain management and avoiding prolonged suffering.
  3. Authority Designation: Consider designating a healthcare proxy who can make decisions on your behalf if you cannot communicate your wishes.

Explanation:

Your advanced directive is a crucial document that ensures your healthcare providers understand your preferences about medical treatments if you are unable to express them yourself. Given your history with cancer and your concerns about suffering, you might want to focus on clear, compassionate care instructions that prioritize your comfort.

Specific Instructions to Include:

  1. Avoidance of Suffering: State explicitly that you wish to avoid painful interventions if you face a terminal prognosis or advanced stages of illness. You might say, "If I face a recurrence of cancer or another malignancy, I prefer that my treatment focus on palliation and comfort rather than aggressive interventions that prolong suffering."

  2. Pain Management: Indicate your preferences regarding pain relief. For example, "I request that medication be administered for pain management as needed, even if it may hasten the end of life."

  3. Prohibition of Prolonged Coma: Clearly state your wish to avoid being placed in a prolonged coma, perhaps by specifying that you would like to refuse life-sustaining treatments if they lead to a state of unconsciousness without hope of recovery.

  4. Healthcare Proxy: Choose a trusted individual as your healthcare proxy, someone who knows your values and can advocate for your wishes in critical situations. Make sure they know and understand your preferences.

  5. Written Guidance: If relevant, include your desire to be informed of any medical decisions made on your behalf. This helps ensure your proxy respects your wishes even when the situation is fluid.

Next Steps:

  • Draft Your Document: Begin drafting your advanced directive with the above points. There are templates available that can help guide you.
  • Discuss with Your Proxy: Have an open conversation with the healthcare proxy you choose about your wishes and the document you’re creating.
  • Legal Considerations: Look into the legal requirements for advanced directives in Switzerland, ensuring your document is valid and recognized.
  • Regular Updates: Revisit your advanced directive periodically, especially after significant health changes or once a year.

Creating an advanced directive is a compassionate act, both for yourself and for those who may care for you in the future. Taking these steps can help you achieve peace of mind regarding your healthcare choices. If you have any further questions or need clarification on specific aspects, feel free to ask.

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