Living Will: Month of Freedom, of being able to decide, of knowing what to decide

The truth is that, if we have the opportunity to defend our will, why not take advantage of that freedom?

The month of April has passed, the month of carnations, the month in which freedom is celebrated. And, as such, I thought this article should focus on your power of decision, your power of choice, that is, the power to live your life on your own terms, without small print or infinite paragraphs.

Therefore, I decided to talk today about the Living Will (TV), also known as Advance Directives (DAV).

We all know that death is the only certainty we have in our lives. But I increasingly reinforce the idea that I have, that the worst thing is not the act of dying itself, the moment when our brain and heart are tired and stop.

The biggest challenge, for the person themselves and all those around them, is perhaps the period that precedes this end of so much uncertainty. These are the long minutes, hours and days during which the patient feels lost in a hospital bed, not knowing what the next day will be like in this continuous journey.

Or, as a family member, experience the duality of emotions, between your desires, reality and the patient's desires.

Even for a healthcare professional, it is a real challenge, knowing how to manage and reconcile the patient's beliefs and expectations with our own and clinical practice, respecting the ethical considerations of medicine.

Therefore, we can try, either individually or together, to alleviate doubts and to somehow prevent that hypothetical situation that, one day, unexpectedly, could be our reality.

Now, the Living Will is defined as a document where we can express, in advance, the health care that we wish or not to receive, at a time when we are unable to express our wishes.

Any citizen, whether national, foreign or refugee, who is resident in Portugal, of legal age, and who is not disabled due to a mental anomaly, can have a TV, requiring a National Health System user number.

Despite the complexity and infinite questions associated with healthcare, I confess that I consider this document accessible, structured and easy to read. This is the first step so that anyone, with more or less support, can express their desires.

The first part of the document is dedicated to filling in the user's (grantor's) identification data. The second – and last page – concerns the selection of the clinical situation in which the VT will have its effects and the care you want or not to receive.

In addition to the options already defined, there is also the opportunity, in an open manner, to describe other options.

Of the precautions described in the document, I highlight the following: not being subjected to cardiopulmonary resuscitation, not authorizing the administration of blood or blood products, receiving religious assistance or even designating a companion who can be with you, when artificial measures are interrupted. of life.

In addition to registering health care, you can also appoint a Health Proxy, in other words, a representative. This entity will be called upon to decide what care should be provided and avoided, always respecting and being governed by your wishes previously expressed in the TV.

To formalize your Living Will, you must deliver it to a RENTEV counter (National Living Will Network) or you can also send it by registered mail, as long as your signature is duly recognized.

However, once the living will is formalized, it is not eternal. Portuguese legislation established that the validity of the TV is 5 years, so it will be necessary to renew it at the end of this period, receiving a prior notice, or, if you change your mind, do so even sooner. Whenever you wish, you can also consult the TV, both on the User Portal and on the SNS24 mobile application.

It is natural that doubts arise, from the relevance of the living will itself, to the care described (such as, for example, what artificial feeding consists of and what it involves).

Personally, and in a rant tone, I confess that my first question is as simple as: “Should I already make a Living Will?”.

After all, I am living my third decade of seemingly healthy life to date. However, despite being a healthcare professional, when I think of myself as a possible patient, doubts and uncertainties irrationally invade my thoughts – I see this reality as something distant, almost impossible to happen, and as such, I have never lost or invested the I spent time thinking about what measures would make me more comfortable mentally and physically. However, as popular wisdom says: “you never know tomorrow”.

Regardless of your age, stage of life or health status, it will always make sense to reflect on the health care you want or not to have, even if these ideas are shaped, as expected, by your person and your experiences. Over time and in your own time.

You don't have to decide anything for tomorrow, but you can start thinking today. And the truth is, if we have the opportunity to defend our will, why not take advantage of that freedom?


Author: Adriana Justo Correia is an Internal Physician in General and Family Medicine


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