By Mary Steiner
Honolulu Star Advertiser
September 23, 2012
Our hearts go out to Karen Okada, who lies dying while her family and the
lawyers argue over her body.
This 95-year-old woman expressed in her 1998 written “living will”
(advance directive) not to have her dying “artificially prolonged.”
We have all heard how important it is to create an advance directive if we
hope to make the journey to death in a manner consistent with our values.
Mrs. Okada’s experience makes clear this is not as easy as filling out a form
and filing it away.
Last month, Mrs. Okada suffered the latest in a series of medical crises that
began in December. Her doctors at The Queen’s Medical Center determined
she was beyond recovery and recommended removing her feeding tube.
A complicating factor is present, though. At the same time she documented
her wishes, Mrs. Okada also completed another equally important advanceplanning
document: She appointed her brother as her health care proxy to
make medical decisions if unable to do so herself. He insists the feeding tube
stay in place.
We cannot know what is in her mind now. Is this the kind of condition she
wanted to continue in? How can you be sure your wishes will be followed?
Compassion & Choices (www.CompassionAndChoices.org) educates,
supports and advocates on a broad range of end-of-life issues. Our
counselors help thousands of people each year find peaceful deaths that
honor the values of a lifetime. They advise that you must not only document
your wishes, but also discuss them with your health care proxy and satisfy
yourself that he or she is the right person to honor them when the time
comes. Make sure your proxy understands your desires, and is able and
willing to see your wishes carried out. Sometimes it can be hard to convince
a loved one that, under certain conditions, allowing you to die will be the
best way to care for you and express love.
Before asking someone to be your proxy, ask yourself, “Are they assertive?
Are their values aligned with mine? Will they respect my choice even if
grief or pressure from others makes it hard to do so?”
Review and discuss these documents regularly. Your family should know
what your wishes are and why. Your doctor also should know where you
stand, and you should feel comfortable that he or she will advocate
respecting your wishes. It appears that The Queen’s Medical Center
physicians acted to respect Mrs. Okada’s directive. Unfortunately, her proxy
demands treatment in conflict with her expressed wishes, forcing the dispute
Compassion & Choices supports an individual’s decision on how to
approach dying. We believe patients within six months of death are entitled
to make their own end-of-life choices. For mentally capable patients, this
includes the choice to request medication to assure the possibility of a
We offer guidance to individuals facing a terminal illness or just planning
ahead, and we work for public policies that support individual choice and a
full range of options at the end of life.