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Everyone in the family knew that Phil would last only another few months more at best; his 88-year-old body was simply giving out. Doctors had treated him for kidney failure, cancer, heart disease, and diabetes over the years, but now the cancer had come back, and Phil did not want to go through chemotherapy again. David, Phil’s mildly retarded son who lived with Phil, wheeled him to the dining room table where family members had gathered to celebrate his birthday. It was February 29, and Phil joked that he had made it to the grand old age of 22. Phil’s oldest son Abe was visiting from  Bulgaria, where he had a successful business that dealt with the Eastern European market. Unlike Phil and David, Abe was not religious. Phil wanted only dessert, so while the rest of the family ate their main course he told them of his decision to die when his time came and not to be “kept alive on machines like some kind of Frankenstein,” he said. Nadia, Abe’s wife, had contacted a hospice care organization that would provide palliative care, social, and spiritual support for Phil at home in his final weeks. Nadia also suggested that Phil execute an advance directive to physicians to ensure that hospital staff follow his wishes for end-of-life care if he were admitted in an emergency. She knew that David would probably call 911 if he found Phil in distress, and would tell the paramedics and the doctors to do everything they could to keep him alive. The same would go for the hospital staff where he would be admitted, unless they had a copy of Phil’s advance directive to physicians.

Abe, who regularly traveled to Los Angles, turned to his wife and said, “Maybe I should look into getting one of these advance directives for myself. If I’m in L.A. and something happens, I don’t want to be kept alive on machines, either.”
What options does a physician’s advance directive give a patient? And what kinds of options does hospice care offer the dying person?

Please visit these Web sites for answers:“I’m Not Trying to Be Cured, So There’s Not Much He Can Do for Me”: Hospice Patients’ Constructions of Hospice’s Holistic Care Approach in a Biomedical Culture from Death StudiesHospice Foundation of America450 words, double line spacingAPA format, 3 credible sources/ references


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