Jul 2 2014

The Danger of Assumption

Dr. Jessica Nutik Zitter’s authentic account in the New York Times recently of an episode with an ICU patient (“Who Can Speak for the Patient”) highlights just how vulnerable we all can be during a healthcare crisis. The randomness of who is on duty, who speaks what language, or when particular family members visit can accidentally influence the choices doctors make and the quality of care we receive.

Dr. Zitter shares what proved to be an incorrect assumption that the only visitor she saw for a particular ICU patient, the sister, was in charge of making decisions for the patient, until she happened to hear there was a wife who visited her husband at night, after her work shift ended. We’ve heard stories of patients unable to communicate who are given the wrong food, forced to hear music that reminds them of something tragic, visited by people they don’t like or given medical treatments they wouldn’t want if only they had been asked and understood. Surely, that is not what is meant by “patient-centered healthcare”?

The time to ask the questions is not during a crisis.

The place to think about, discuss with loved ones, and document your answers is wherever you’re most comfortable – usually that’s the kitchen table surrounded by those who are most important to you, at a moment when you have the gift of time and are not stressed by an emergency, not the operating table.

Everyone 18 and over should have a conversation with their loved ones and record their wishes in an advance medical directive, securely stored online in the cloud, easily updated and accessible at anytime. If we can send probes and use telescopes to detect signals from galaxies beyond our clouds, isn’t it time for true healthcare reform to embrace the best technology and use “the cloud” to ensure all of us have a voice in our healthcare? is the first free online advance medical directive service. There has been growing attention to the issue of advance care planning nationally and in the media – but what’s critical to comprehend is that advance directives are for everyone, at all times. Initiating these conversations and creating advance directives helps us all to lead our lives with a sense of peace, confidence and control.


Advance Medical Directives Healthcare ICU Jessica Nutik Zitter MyDirectives Patient

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