Q: I am 76 years old and have recently been diagnosed with cancer. I do not know if it will be fatal, but just in case, I would like to make a living will. Do you think this is a good idea? I live in Alberta and I understand that there is a provincial act dealing with this matter. Do you know what it is called and where I can get the forms?
A: There are several reasons why it is a good idea to make a living will. The main one is that you may be unconscious or mentally incapable of making a sensible decision closer to the time of your death. This may not be due to the cancer, which may not incapacitate you mentally as much as Alzheimer’s disease or a stroke.
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The other problem is that well-meaning relatives may want to keep you alive as long as possible, for their benefit, not yours. They may not want to let you go, but this might increase your pain and suffering.
In the living will you might state that you do not want any CPR (cardiopulmonary resuscitation), mechanical respiration, or intravenous fluids or tube feeding if you are about to die, but you might perhaps want antibiotics, or fluids or food by mouth. Legally you cannot ask for euthanasia or doctor-assisted suicide.
In Alberta, the law known as the Personal Directives Act came into effect in December 1997. It only deals with personal and medical matters and has nothing to do with financial matters, which are dealt with by an enduring power of attorney or appointment of a trustee if you are a dependent adult.
The personal directive may appoint aperson to assess your mental capacity to make decisions regarding your health. If that person is not a doctor, the assessment has to be in consultation with a physician or psychologist.
If you do not do this, then two physicians or one physician and a psychologist must make a written declaration of incapacity.
You do not need any special forms to make a living will or a personal directive, although you may wish to consult a lawyer or your doctor to help make the correct decisions. It only has to be written in your handwriting, not typed, and be dated and signed by you and a witness.
It is best to keep a copy of this document near the front door of your house or apartment so that in an emergency, the ambulance drivers or paramedics will see it. They may not find it, and there is always a risk that in an emergency, the workers will still perform CPR. If you are in a nursing home or hospital, this should not happen if the facility has the document and your wishes noted on file.
Benefits, risks of vitamins
Q: Will taking vitamin supplements or beta-carotene lessen my risk of a heart attack or stroke?
A: Recently the United States preventive services task force reviewed four studies that looked at the benefits of taking vitamins A, C, E, multivitamins, folic acid and beta-carotene. It found no clear evidence that taking these substances reduced the risk of heart attack, stroke or cancer, and in fact found that even moderate doses of vitamin A could reduce bone mineral density. High doses could cause liver damage or cause harm to an unborn child.
Vice-chair of the task force Dr. Janet Allan said, “vitamin supplements may be necessary for individuals whose diets don’t provide the recommended amounts of specific vitamins and especially important for pregnant and nursing women and people with specific illnesses. However, the benefits of vitamin supplements in the general population remain uncertain.”
Clare Rowson is a medical doctor with a practice near Belleville, Ont. Her columns are intended for general information only. Individuals are encouraged to also seek the advice of their own doctor regarding medical questions and treatments.
