Connecticut Lawyer Sept '05
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P.O. Box 1399
Connecticut 06039
Phone: (860) 435-2077





The Importance of Health Care Directives in the Time of COVID-19

Our current health care crisis has led to heightened awareness of the need for advance health care directives. COVID-19 can result in a sudden and unexpected deterioration of health, making communication with health care providers difficult or impossible. It is more important than ever that you name, in advance, persons whom you trust to make or communicate treatment preferences and decisions if you become unable to do so.

Preferences may range from wanting all reasonable steps taken to preserve and prolong life, to comfort care only, or somewhere in between (“selective care”). The first is categorized as “full treatment” and is the default form of treatment in the absence of advance directives. This might include hospitalization in the Intensive Care Unit (ICU), being put on a ventilator, intubation, cardiac resuscitation, intravenous medication and fluids, and long-term tube feedings. At the other extreme is comfort-focused treatment, which might include hospitalization if needed for comfort care (but not in the ICU), oxygen, suction and manual airway treatment for comfort, medications, food and fluid by mouth, but would not include CPR, intubation or use of a ventilator. Selective treatment might include non-invasive treatment, such as non-invasive positive airway pressure, IV medication and fluids, and short-term tube feedings. You should identify the goals of your care, from living as long as possible to living only if quality of life can be maintained, and specify treatments consistent with those wishes. You should also communicate your wishes in advance with your chosen health care decision-makers and, if possible, your health care providers. For example, would you want to be hospitalized? If so, for what purpose? Would you want your DNR orders suspended, or enforced, in the event of severe complications of COVID? Would you want to be in a medically induced coma with a breathing tube, IV for anxiety and pain medications and hydration, and a feeding tube keeping you alive? Or would you want no heroic measures to be taken?

A simple statement to the effect that you do or do not want CPR, artificial nutrition and hydration, artificial respiration, and other interventions, in the event you contract COVID, might suffice. Alternatively, you may want to attach an Addendum to your health care directive setting out your specific preferences with respect to hospitalization, intubation, use of a ventilator, and CPR in the event you contract a severe case of COVID.

Regardless of your preferences, this is a critical time to prepare a health care advance directive, or to review your existing directive, in light of the current public health crisis.




Please feel free to contact me if I can be of any assistance with your Advance Directives.