When a Spouse Won't Agree to Your EOL Plan

A woman wrote to Slate's Dear Prudence to say that her husband won't talk to her about end of life choices or support her wish to have a DNR and palliative care only if she gets COVID-19.

Prudence's answer:

There may be more you can do to ensure your wishes are respected even if your husband never comes around. Having a DNR is a great start, but you may also want to draw up a living will, which can address treatments beyond just resuscitation, such as ventilation, tube feeding, dialysis, and antibiotics. You can also set up a trusted friend or relative with power of attorney. The Mayo Clinic has a rundown on the difference between a living will and a DNR directive, as well as what you might need to enforce and validate both.

It should be easier to insist that your husband have a practical conversation with you about end-of-life care if you’re not also worrying that your fate lies in his hands. You can tell him: “I know you don’t want to think about either of us dying. Death is going to happen whether we plan for it or not. I can’t force you to talk about it, but if we avoid the subject forever, it won’t make death any less real. It will just mean that I have to make plans alone, and I would rather go through this part of our lives the way we’ve gone through the last 40 years—as partners. I want you to know which directives I’ve established with my medical proxy, and I’ve made a copy for us to review together. I know you’re not up to acting as my advocate yourself, but I want you to know what you can expect. Can you give me an hour of your time to discuss this?” If you think it would help to have a mediator, you might schedule an appointment with your doctor to review your various directives and ask your husband to join you. That way he won’t have to participate in anything he finds too overwhelming, but you’ll have the peace of mind that he knows what’s going on. I hope you can find ways to get through to him: It’s easier to get through even the most painful scenarios if you have a companion, and he needs you as much as you need him.