Advanced Directives

Orthodox Advanced Directives

Advanced Directives can be difficult to understand.  It is important for all of us to try and wrap our minds around them.  The reason for this is that eventually each one of us will get sick and die.  Therefore giving direction to your healthcare team and loved ones now that you have your faculties makes decision making about important interventions during these critical times in our lives that much easier for them and relieves them, especially family, of unnecessary burdens.  We prepare for disability and death in so any other ways by buying insurances and preparing a regular will, it is truly remiss for us not to consider caring for ourselves and family with some attention to advanced directives.

Advanced directives are legal documents that that help you doctors and family members understand your wishes about medical care that you will receive if you are unconscious or too weak to talk.  Advanced directives  are “advanced” because you instruct your medical team ahead of time your wishes, and they are “directives” because you give direction to your health care team what you want.  They are “Orthodox” because you bring to the directives your Orthodox Christian understanding of what your healthcare team should know about your highly personal, and often end-of-life, healthcare wishes are.

Generally there are two advanced directives, the “Living Will”, and the “Health Care Proxy”.  Here we will briefly describe each of these.  However, there is a great deal of information regarding these almost anywhere you look, on the web, at your physician offices, hospitals and other healthcare institutions including nursing homes and other skilled nursing facilities.  We will offer here a version of Orthodox Advanced Directives that have been created by two OCAMPR physicians who work closely with very ill patients, one an Oncologist, Deacon Peter Bushunow, MD, and the other a Cardiologist John Demakis, MD.

Often attorneys are not needed for such directives, however, it is always a good idea to have your attorney look things over so that it is clear to everyone what exactly you want and so that you have a higher degree of certainty that these wishes will be met.

Living Wills are documents that clarify which treatments you may or may not want to receive if you are too ill to decide for yourself.  Such end-of-life wishes of a patient including but not limited to “do not resuscitate” orders, specifics about invasive interventions such as feeding tubes, medications and hydration.  They also might clarify who the patient wishes to have the healthcare team notify in the event of an emergency, including Orthodox pastors.  If you do not have a living will decisions about your care will be made based on what is known about you but may not be consistent with your wishes.  It is therefore a good idea to discuss these issues with your doctors and family and formulate a clear treatment plan for severe illness early.

Healthcare proxies are the documented wishes of a patient that clarify who will be a surrogate decision-maker for an individual should he/she be incapacitated as a result of an illness, and unable to make their own decisions.  It should be noted that an individual assigned as healthcare proxy does not make decisions “for” a patient, rather he/she, knowing the patient well (spouse, parent or child) will share these wishes with the healthcare team.  This understanding relieves the proxy of the undue burden of “deciding” for a patient and instead, “speaks for” the patient.  However, the proxy or “durable power of attorney” is empowered by the law to make healthcare decisions for you in the clinical setting because he/she knows your wishes.

To understand more about Living Wills and Healthcare Proxies Deacon Peter Bushunow, MD has written about them here,

Father Thomas Hopko, in an interview on Advanced Directives, clarifies important aspects of Living Wills and Healthcare Proxies from an Orthodox viewpoint here.

Father Steven Voytovich of the OCA, a chaplain of Norwalk Hospital in Connecticut and pastor of St. Alexis Mission Church in Clinton, CT also writes about Advanced Directives here in a well referenced article.

As Orthodox Christians our main goal in life is achieving salvation.  While preparing advanced directives may or may not affect this goal, knowing you can have an Orthodox pastor be a part of this difficult and most important time in your life – severe illness and perhaps your falling asleep – is a relief not only to you, the patient, but also to your spouses, parents and children and makes care for you at the end-of-life less burdensome to loved ones and those caring for you in the hospitals and at home.

In addition to this discussion and ministry on Advanced Directives, in this section of our website, we thought it fitting that we look beyond our falling asleep and to burial.  There is a wonderful book that comes highly recommended and we encourage our readers to think about acquiring it if they are interested in Orthodox burial traditions and this aspect of final care for the body.  It is “A Christian Ending” by Deacon J. Mark and his Matushka Elizabeth J. Barna.  Fr. John Cox, our Vice-president at the time of this writing had this to say in the Reading Corner of our website.

Death and burial aren’t exactly popular topics of discussion and if you try to make them so people will probably stop inviting you to dinner parties but for Orthodox Christians they are important aspects of our faith.  Many Orthodox Christians may be unaware however that the Church has a traditional way of going through the process of death and burial that has little in common with the world of funeral homes; a way that is both more meaningful and less expensive. THIS book by J. Mark and Elizabeth Barna brings that tradition of death and burial to light and shows us the way to reclaim it today.  As a testament to the value their work the Orthodox practices Deacon Mark and Matushka Elizabeth describe were successfully employed in the death and burial of the ever-memorable Archbishop Dmitri, retired Archbishop of Dallas and the South (OCA).

We hope that this section of our website helps you in your planning for severe illness and your passing from this life to the next.  While it is indeed a difficult topic, it is important to you and to your families.

But be of good cheer; I have overcome the world.  John 16: 33

Christ Is Risen!  Indeed He Is Risen!