How to take control of your medical choices – Advance directives in South Africa

One of my favourite scenes in the Netflix series “Grace and Frankie” is where Jane Fonda and Lily Tomlin get so fed up because they are ignored as older women that they steal a pack of cigarettes – not being caught for theft being the only advantage, as they say, to becoming invisible in a world that values youth.

Why advance directives are important

And whether it is true that we become more invisible as we age or not, there does come a point in our lives where others feel more competent to make decisions on our behalf. In some instances that is inevitable – where we are not able to voice what we want.

A medical directive that tells people what we will want when we can no longer voice it, is a way in which we can influence these decisions.

How the DignitySA tool works

DignitySA is an NGO with the vision of a “South Africa where all of us are supported throughout life's final journey with compassionate care, dignity, and the freedom to choose our own path.” They have developed an online tool to work through what we want when we are no longer able to voice that. It takes into account that sometimes aggressive medical intervention is not what is needed.

The tool allows you to work through what kind of treatment you want in very particular situations so that you can draw up what is called an advance directive. Importantly, as with all legal documents, these should be shared with people that need to know what to do – your doctor or family.

It is also good to discuss this with your doctor and a great time to find out whether you are on the same page regarding medical choices!

The role of a medical proxy

You can also appoint a medical proxy. This should be a person you have discussed the details with and who will insist that your wishes are respected in any of these situations.

Are advance directives legally enforceable in South Africa?

It is not strictly a legally enforceable document, but the Health Professions Council of South Africa (HPCSA) has issued guidelines that medical staff should consider an advance directive to be the representation of a patient’s wishes and comply.

I now carry in my wallet a card that says I have an advance directive and who my medical proxy is. I also carry an organ donor card, but that may be a topic worth discussing in another article.

And as always, once you have made these arrangements, put it aside and focus on the life you have. 🌻

Here is a link to the DignitySA document : DignitySA advance directive

If you want to have a more comprehensive conversation about end of life choices, please feel free to contact me on email at meerkatphilosophy@gmail.com

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Meet Britta Rotmann

Britta is an end of life companion doula who shifted from a varied career in law, government, international organisations and NPOs to the more sacred work of being with people at the end of their life. Although her BA, LLB and Masters in Law bring relevant knowledge to the field, it is her ability to ask the tough questions and sit in difficult conversations that is her core competency in this work.

Britta writes about what makes our end of life processes easier so that we can focus on the sacredness of this time. Contact Britta at meerkatphilosophy@gmail.com or read more about her here.