CON: Families find peace in honoring final wishes

Keldy  Ortiz

May 19, 2013 at 12:19 a.m.

Alzheimer's disease slowly robbed Hilaria Adame of her most prized possessions - her memories.

Death was inevitable as the affliction progressed, so Adame, then in her 70s, took control of her own mortality, asking that she not be resuscitated and that she not go through invasive treatment to keep her alive.

She wanted to go in peace.

Adame died in March at 81, and though her death was difficult for family, her 54-year-old daughter, Esther Castillo, said she understood her mother's wishes.

That's how it should be, Castillo said.

"I did not question it," she said. "I felt this is her life, and this is how she wanted to deal with it. It was her choice to do it that way, and I wanted to honor her wish."

The pending Senate Bill 303 would give families a longer timeframe to challenge a doctor's orders - 21 days - instead of one week. A revision of the bill added it would require water and nutrition be provided to patients as long as the family wanted, and it also would stop doctors from issuing do-not-resuscitate orders.

This means patients with advanced directives, or living wills, would have the most power.

A law like that would put more families at ease, Castillo said.

"We should not leave it up to the doctors to make all the decisions," she said. "It depends on the circumstances because there have been instances when doctors have made medical decisions that were unnecessary or harmful medical decisions."

Castillo's mother made the decision to sign do-not-resuscitate paperwork after her husband, Antonio Adame, died of cancer in 2006.

Patients like Adame aren't the only ones taking matters into their own hands.

Karl Craigie lived with dementia and died at 83 in his home, leaving his widow, Phyllis Craigie, at ease with his final moment.

"Karl and I had discussed end-of-life and what should be done," she said. "There shouldn't have been any surprises."

Arlo Weltge, a Houston emergency room physician, said end-of-life discussions are difficult for families and doctors.

Weltge said doctors try to provide an appropriate level of care, which is based on the respecting the deicsions of the patient, family and doctor.

"When it comes to end-of-life (care), our goal is to see the patient's wishes are followed," Weltge said.

Craigie knows her husband living his last days comfortably is what he wanted, but she knows others may want their end-of-life care to be different.

But one thing remains clear - the families should have that final say, she added.

"It is not a small job to take care of a person who is dying," Craigie said. "You want to do everything you possibly can."

Advocate reporter J.R. Ortega contributed to this story.

PRO: Doctors should be part of end-of-life care decisions



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