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Psychiatric Advanced Directives

Psychiatric Advanced Directives

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I believe in healing & I believe in recovery. After surviving so many tragic circumstances and injuries, I fully understand how fragile life is and why we must protect ourselves from both seen and unforeseen events which put our health and safety in jeopardy. This presentation is a discussion on the importance of having psychiatric advanced directives. For the past few years, after my break, I have tirelessly searched for a health care proxy. A health care proxy is someone charged with making medical & psychiatric decisions in the event the a person becomes incapacitated. Speaking from a position in which I was deemed incapacitated, or in plainer English, insane, I know full well that people need a point person to make educated and very personal decisions by proxy in the event you or someone you love cannot speak for themselves.

While I believe so passionately in healing, rallying back, and recovery I also believe in the beauty of radically accepting Palliative Care/Medicine and the importance of a peaceful transitional life experience when my journey here is almost complete. I have interned in cancer wards, lived in psychiatric wards, and been ripped out of a car with the jaws of life to live in a rehabilitation ward in a hospital which would help me learn how to walk again. These experiences paint the search for a proxy with an intensity felt frequently by myself and family & friends concerned about my care in the event of future tragic circumstances.

Indeed, I am still searching for the right fit and point person to carry out my will in the event I lose capacity and/or am too sick to make medical and psychiatric decisions. Recently I began screening candidates & vetting them for their moral, ethical, and spiritual values. When psychiatric decisions are involved, as complex as human anatomy is, questions about mental degradation and quality of life after psychiatric emergencies go even deeper in a vast well of uncertainty.

After ten years I still haven’t made a final selection to proxy my will. Tirelessly, I have put out flyers and solicited friends & family to fill out applications for the position of my Health Care Proxy in my transitional life team but no one has answered my calling. There is no question that this might also entail co-morbid radical medical interventions in which both my physical health & mental status is so compromised I cannot make decisions regarding my care. if any.

For your own search, I recommend rigorously interviewing all qualified applicants and asking them about their availability to meet for bi-weekly updates and revisions to your preferred life-sustaining interventions and other medical & psychiatric treatment that captures your philosophy regarding transitional life events. Identify early on their take or stance on recovery which will undoubtedly shape their future decisions about your care. Applicants should be required to prepare a presentation on their approach to executing Advanced Directives given the limits of the law and medicine as well as your personal philosophy regarding transitional life care.

Remember, ultimately, this is about your care and treatment when you cannot be present to make decisions. Make the right decision today and appoint a proxy colluding with your interests.

About the Author

J. Peters

Bold 10 Under 10 award recipient Jacques Peters ’08, MSW ’12 . Through his work as a Licensed Clinical Social Worker (LCSW), therapist and disability rights advocate, Mr. Peters fights for those without a voice in various systems of care, such as the New York City Department of Social Services, the New York State Office of Mental Health or the city’s Department of Corrections. Jacques is the author of University on Watch: Crisis in the Academy, which he published under the pen name J. Peters in 2019, and First Diagnosis, published in 2020. Jacques refers to his stance on recovery in his journal articles as “Too big to fail.” No obstacle too big, no feat out of reach, Jacques let nothing stop him in his path to recovery and healing.
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