Cremation, Autopsy, Organ Donation: What Do Clients Choose?

The purpose of an Advance Health Care Directive in California is two-fold. One, it allows you to appoint an agent to make medical decisions for you. Two, it allows you to indicate what your wishes are with respect to end of life choices. See my in-depth post on this topic.

To prepare Advance Health Care Directives for my clients, I need to know how they feel about certain things. I tell my clients to go with their first impression or if they are not sure to get back to me in a week's time with their choices.

I ask how you feel about cremation and burial. My clients are split down the middle with this one. Half feel strongly about cremation and the other half feel strongly about being buried.

I ask how you feel about organ donation. My clients, again, are split down the middle. Many of them say yes without any hesitation. And the remainder say no unequivocally. Some take a while to decide.

I ask how you feel about an autopsy if needed. Most say yes. It's not a given that an autopsy will be performed. An autopsy is only ordered or requested when the cause of death is unknown. See this informative article about autopsies from Aurora Healthcare.

I also ask you many other questions relating to your religion, your primary care doctor, nominating a conservator and, of course, how you feel about end of life choices.

I have sample end of life provisions on a chart. The chart contains 4 choices on a continuum of sorts. The chart is only a guide. You can choose whatever you like and even modify or add to the choices.

On a personal note, the chart bothers me. I am bothered by the semantics. I have numbered the 4 choices in order from 1 to 4. It reads like a fast food combo meal menu. I have to laugh because it is so absurd. So I try not to refer to the items by number. I review them and we discuss. I could refer to them by letters, but that still doesn't really remove the fast food like mentality. I created the chart and it works well in my practice. Maybe it is only me.

Interestingly enough, one of the choices is a variation of that I wish to remain alive as long as possible and want to continue medical treatment. I have had exactly one person choose this. It was a young person who felt that they were invincible in life. Nearly everyone else has a modification on a theme providing for termination of life support or other medical treatment if death is imminent.

It is very interesting to listen to people talk about these things. There is no rhyme or reason to our thoughts sometimes on these important issues. But respecting my clients for making these decisions so that their loved ones will not have to second guess them gets them an A+ in my book.