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How can I decide if I should be kept alive if I can't talk for myself?

Many advanced medical technologies aim at rescue, which means that under normal circumstances, without the treatment the person would die -- usually from the failure of an organ. For example, there might be a small-to-moderate chance that with a ventricular-assist device (an artificial heart), a particularly ill person could be kept alive until an organ became available for transplant.

Informed decisions about lifesaving techniques are critical. Under those circumstances, one is shooting for an uncertain or perhaps even improbable benefit, with a high likelihood that the "miracle" won’t happen and decisions will need to be made about future treatments. Frequently, those decisions need to be made when the people can’t talk for themselves. Therefore, the use of advanced technology necessitates an in-depth and detailed discussion with the person or the people making decisions for the person about the purpose of the technology, what will happen if the technology doesn’t achieve the intended goal and how the person would feel about that.

This makes high-quality conversations between the treating team and the affected person and his or her family particularly important. Such discussions should clearly and compassionately identify the spectrum of potential treatments, conveying the likelihood that each approach will be successful and what that success would mean -- as well as the potential adverse outcomes and the health states they would produce -- to determine the person’s preferences and goals.

These are difficult conversations. The last thing that a really sick person wants to focus on is what life will be like after a massive stroke. However, without such conversations beforehand, he or she might end up undergoing unwanted life-sustaining treatment.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.