The Lady In 8D on The Porter Flight To New York:

Posted on in General

We settled into our seats. I was in 8C. There was a lady sitting next to me in 8D.

She was a confident, articulate, attractive management consultant. She had children in their 20’s. Her husband was a very successful manufacturer in a family business. She was on her way to New York to the Freeze art show.

We spoke about her work. Then we spoke about my work. I explained that we did complex case management. No one get’s it until I describe a few cases. Then it is obvious. Why aren’t more people doing this type of work. It is so important.

We finally spoke about a topic that kept surfacing at dinner parties that she attended. The topic was doctor assisted suicide. She was pleased that the Supreme Court had voted in favour.

She said that if she had a terrible disease, then she would have advanced directives that included her option of doctor assisted death.

In fact, she said that she would want this to happen at certain date and time.

I did not bring up the idea that it might not happen. If she was in a hospital, then her advanced directive might not be communicated to the doctors, interns or residents. There might be confusion about her wishes. The doctors values might trump her wish for a seamless death.

It became apparent that in order for her to have an exit with dignity and no pain at the appropriate time, that her advocate would have to be at her bedside.

And so arose the concept of “bedside patient advocacy”. In order for the patient’s wishes to be realized, someone knowledgeable will have to be at the bedside communicating her wishes to the team.  If not, her wishes might not happen.