The patient’s disposition is used in case of an accident or for medical reasons to define in advance which medical measures the patient accepts and which he or she rejects. Therefore, each of us should take the time to fill out an appropriate form while we are still able to express ourselves about medical measures. In this way, doctors will take into account one’s will and outlook on life. It also prevents family members from making decisions for the patient if one is not on good terms.
When do physicians use the patient’s wishes? In case the patient is unable to personally express his or her wishes regarding a treatment, if he or she is unable to form an opinion about it, and/or if he or she is unable to communicate it. This may occur in the case of illness or injury. In such a case it is referred to as incapacity.
Who can fill out the form? Any person capable of discernment can write patient dispositions, that is, when one is still capable of understanding: it is important to think about this before a serious illness and to take into account that one does not know if and when accidents will happen.
The drafting of patient dispositions should be written in one’s own hand and not by another person.
What types of pain treatments and therapies can be chosen? Regarding types of treatments: one has to take a position on different constellations such as emergency situations, sudden or severe illness and injuries, whether doctors will have the therapeutic goal of prolonging life with intensive care and/or resuscitation at any cost or whether they should relieve suffering without trying to prolong life through medical measures.
Regarding pain therapies, one has to make a judgment as to whether one prefers full treatment, which could reduce remaining life, or partial treatment where the patient endures pain and is conscious.
What kind of questions does the form contain? Because cases may occur in certain cases, where it is not clear to the doctors how to treat the patient, there are questions about the patient’s opinion of life so that the doctors know whether to prolong life or not. These are questions like:
What gives her joy in life?
What worries or scares her in life?
If she imagines dying soon, what comes to her mind?
As an attorney and life counselor, I open my doors to those who want to discuss these issues.
When is the patient’s disposition considered valid? The date of writing and the patient’s signature should be on the form, and it is advisable to update the disposition every two years. However, there are cases when doctors doubt that the patient has understood and answered the questions correctly and decide to prolong life and relieve suffering. Here are articles on the subject:
https://www.beobachter.ch/gesundheit/medizin-krankheit/warum-viele-patientenverfugungen-im-notfall-nicht-helfen-168314
https://www.srf.ch/wissen/gesundheit/patientenverfuegung-ein-formular-allein-reicht-nicht
I therefore recommend that you choose the detailed version and fill it in with the help of an experienced person instead of the short version. I am available to my clients as a trusted person to be included and then discuss your treatments with the doctors.
What do you recommend as an advocate? Each of us has different approaches to life due to our religion, culture, and spirituality. These values and beliefs impact the answers doctors need to determine therapeutic treatment and medical measures. It is important to talk about them within the family and with people we trust. To make sure that you can give the right answers, I recommend that you seek the advice of an expert and talk to your doctor about it as well. I am also available to help you formulate clear answers and advise you on all the various aspects of the patient’s disposition, including those concerning organ donation and end of life.
Since the form also requires you to designate a representative, I can also be available to you in this regard, as I will be able to indicate to the doctors how you would like to be treated and be available to your family.
What if you have not drafted the Patient’s Dispositions or appointed a representative? According to Article 378 of the Swiss Civil Code, the following persons have the right to represent the patient and to give or withhold consent to the planned medical measures, in that order:
- the person designated in the patient’s directives or precautionary mandate (representative);
- the curator with the right of representation in the case of medical measures;
- the spouse or registered partner who lives in common household with the person incapable of discernment or provides regular care for him/her in person;
- the person who lives in domestic partnership with the person incapable of discernment and personally provides regular care for him/her; and
- descendants, if they personally render regular assistance to the person incapable of discernment;
- the parents, if they personally provide regular care to the person incapable of discernment;
- brothers and sisters, if they personally provide regular care to the person incapable of discernment.
This order stipulated by law applies even if, in the patient’s dispositions, no representative has been appointed and there is no stance regarding the patient’s willingness to receive certain treatment.
For an appointment contact attorney Dominique Calcò Labbruzzo at + 41 78 876 82 43 or email calco@holistic-law.com.