I would try to imagine and spell out what kinds of medical treatments I might want or not want in some future crisis when I was incapacitated and no longer able to express my preferences. Mostly, I wanted to see how difficult it would be—whether it was something ordinary people could do without discomfort. The whole process felt unnatural and uncomfortable, like a role-play exercise at a company training seminar. From the vantage of middle age and good health, trying to visualize and then discuss some undefined, distant future crisis just felt stiff. I couldn’t figure out how to bring the process to life until I decided to write an addendum, an attached advisory outlining my values as best I could express them and what would be most important to me regarding medical treatments and decision-making.
I completed my advance directive and then filed the article. But my editor promptly decamped
for Paris. His replacement found it unconvincing and it never saw the light of day... until now. So my hope is that highlighting my process will show that it is possible to complete an advance directive and live to tell the tale, and perhaps remind others with an interest in care at the end of life that they should bring that interest down to the personal level and do their own. For themselves and those who they love.
But I learned a few things about advance care planning along the way. I learned that a living will containing a laundry list of wanted and unwanted treatments for some distant future crisis is less useful than thinking about underlying values and then communicating them to someone we could represent them through a DPOA. I think a professional guide to the process could be a lot of help; otherwise, don’t feel surprised if it feels a little formal and stiff and unnatural.