End of Life Paperwork: Should you hire a consultant?

Posted on June 18, 2012 by


Jane Brody’s recent article on advanced healthcare directives in the New York Times gave voice to something I’ve been wondering for a long time. These forms have gotten increasingly complex over the years. I know because more and more friends, relatives and relatives of friends are sending them to me to review. Can anyone who is not a trained medical professional really understand what they mean?

I’m not talking about the language. The forms might be written in painstakingly clear prose such as “I would only choose to be on a ventilator to treat a reversible illness.” But who really knows how long a “reversible illness” might take to improve? What if the patient, while undergoing treatment for pneumonia, develops a complication or a different illness that is not reversible, e.g. kidney failure?

It is for this reason that professional consultants are now cropping up to help interpret the forms-to match the written words to the stated wishes of the patient. As the article points out, these services are pricey, an estimated $1500 per consult, more than a lot of folks pay for wills.

Healthcare directives are definitely an improvement over the days when the options for patient input were limited to whether to make someone a DNR (Do Not Resuscitate) or not but there is no such thing as a failsafe roadmap to end-of-life decisions. There are just too many variables for any one document of any reasonable length to cover. There is no substitute for thorough and repeated communication between physician and patient and/or a patient’s family to ensure that final wishes are met.