My Living Will

I have done  LOT of research on ways to finally follow through on a solution to everything.  No more being a backseat driver in my own life, no more pain, no more fucked up flashbacks, no more...well you get the point.

http://www.dailymail.co.uk/news/article-1078439/Woman-swallowed-anti-freeze-dies-refusing-treatment--doctors-feared-assault-claim-saved-her.html

The best bit, the law was reviewed since so now under the Mental Health Act, you have to be deemed "competent", or at least, "not lacking capacity", in order to refuse medical treatment.  The law here in Northern Ireland still dictates that if you have a living will, or advanced directive as they are otherwise known, it has to be abided by regardless because the Mental Health Act doesn't apply here, but the laws on advanced healthcare directives do.
I have officially found  back door that means that a doctor cannot lay a finger on me should an alter bring me to hospital after a suicide attempt.  It means that I can choose whatever method I like and still be able to resent to the hospital for treatment to include pain relief and sedation should it be needed, and while there, unconscious or conscious, I cant be treated for whatever I have ingested to get me there.

On Friday night I attempted throwing myself into the River Foyle.  Went there, couldnt do it from this side of the river as it was too well lit, spied a dimly lit part where I was less likely to be seen (and 'rescued'), so made my way over.  When I got there, I was met head on by three guys in jackets, I can only assume was Foyle Search and Rescue.  For those of you who dont know who they are, it is their primary aim to thwart suicide attempts in and around the river.  Needless to say, I quickly changed my route, and came back later.  I was so scared of the same thing happening again, or bumping into them and it somehow being written all over my face what I was there for, the I decided to have a stab at it from the better lit area, and traffic flow was a lot lighter, I figured the risk of someone noticing me in dark clothes wanting to jump in, would be lower.  I made my way round the other side again, only to see the same guys standing at the other side.  I didnt want to double back on myself as I felt them seeing me twice already, surely they would know what I was up to, so I walked the opposite way home (so as to avoid having to walk past them) and had a meltdown.

That is when I started really thinking outside the box of how I could go about this.  I dont want to fuck someone up in the head by them finding the body.  I dont want to do it here, as then the staff here would have to deal with the body.  A lot of young people live here, and when word got out that someone topped themselves....they are an impressionable bunch I think; I dont want to be responsible for someone thinking it was a good idea because someone geographically close to them did.  I want a method that will be quick, but as painless as possible.  I want to go peacefully, or as peacefully as possible.  It would be easier to be able to take an overdose and die, but I cant do it here and dont have the money for a hotel peak season in a tourist trap.  So, with a living will, it covers everything.  I can have my cake and eat it, and not have to worry about shitting on the people here.  Healthcare professionals deal with death everyday.  It wont faze them to see me die.  The support workers here deal with trying to help people get their lives together and are a really good bunch of people.  It isn't fair to expect them to clean up that mess.  I dont have the heart to do that on them.
Flat will be cleaned, belongings packed, notes will not be left this time around.  I will do the deed, wait a certain amount of time, and when I feel consciousness fading, I will ring an ambulance with a copy of the living will and a letter saying what I am expecting from going to hospital (i.e. painkillers and sedation if needed, but ultimately, somewhere to die).

There is just a small hitch in the plan.  For it to stick here, I need to give a copy to anyone involved in my care.  I am afraid by giving a copy to my GP it will mean I will be sectioned on the spot, but I am sure I can avoid it should it come tam planning appropriately for upcoming events in my future, therefore I am the embodiment of sanity.  I doubt that will work actually.  Will say I am simply making out a detailed living will should the need arise and I have no future plans to inflict any harm on myself.  If I stick to my guns and (fingers fucking crossed) not lose time to an internal meddler, all should go according to plan.  I have been working on this for nearly a week now, just have to print off a couple of copies, then I am good to go.
It's hardly as if they can review the law here in the space of time it would take to give the document to those who are required to have it and me offing this circus.

Here is a copy:

Living Will

I, (my name) (Date of birth 0*-0*-198*) of (my address) being of sound mind, voluntarily make known my wishes that my life should not be prolonged as long as possible in all circumstances.

Treatments

If at any time I develop a critical condition that will result in my death in a relatively short period of time (days or weeks), decline into a persistent comatose state from which there is no reasonable expectation of regaining consciousness without medical treatment, decline into a persistent vegetative state from which there is no reasonable expectation of regaining cognitive function without medical treatment, please note the following:

In these circumstances I wish life saving treatments be used or withheld or withdrawn as specified below. I wish to be permitted to die with dignity and I am grateful to those that respect my free and informed choices.

I do not wish to receive artificial nutrition or artificial hydration. I do not wish treatment with antibiotics. I do not wish a ventilator or other artificial respiration support to be used to sustain my breathing, however difficult breathing becomes. I do not wish serum or urinary alkinisation through any method. I do not wish to receive GI tract decontamination. I also do not wish to receive heamodialysis or charcoal heamoperfusion. I do not wish to be catheterised. I do not want blood or blood products. I do not want invasive diagnostic tests. I wish treatment for the easing of pain to be administered as necessary, even if this might hasten my death.

If an ambulance is called by myself in a situation that may lead to death, it is not because I want life-saving treatments, it is so staff at the housing association will not be forced to deal with my body, younger residents will witness my death in no way, and I can receive appropriate pain relief/sedation should the need arise.

I request that my living will be honoured by my medical team, as a final expression of my legal right to refuse medical and surgical treatments even if my life is at risk by so doing.

If any doctor treating me will not agree with my wishes, I ask that my care be transferred to another doctor, or healthcare provider, who will respect them. This transfer should be done as quickly as possible and with the utmost respect to all concerned.

Organ Donation

I wish to donate all my organs and tissue for transplant.

I agree to my organs being used for medical or scientific research.

Final Declarations

I understand that I may change my mind at any time and revoke or update my Living Will.

Should I do this I understand all previous editions of my Living Will will become invalid and

should be destroyed.

I understand that a signed copy of this form will have the same status as the original.

It is my wish that no legal action is taken against anyone because they have acted in good faith in

accordance with what I have requested in this Advance Healthcare Directive.

I understand it is in my best interest to lodge a copy of this signed Living Will with my doctor and/or medical team.

I am of sound mind and am 18 years of age or older.

Signature                                                   Date

______________________________    _________________

You see, you have to be very specific in these things I found.  Every single piece of legislation and every case study I came across demonstrated that to say no to treatment, you need to be specific in what you are saying no to.

I have a way out, and fuck it, even if I m admitted to that infested dump of a hospital again, when I am discharged, there will still be a copy of this on my file, I will still have met all the stipulations, and I will make sure I have a copy pinned to me when I call the blues and twos.  I still have an end in sight.  And no fucker can take that from me, butterfly net and white coat or not.

Breaking down the break down

I was sitting on the sofa, from where I hadn't moved in (insert random guess here). I lost time for I don't know how long, and when I did come round, I noticed cuts on my arms and thighs. I probably needed stitches on my right thigh, but to be honest, going to A+E for stitches, even when I am not an emotional wreck, is not something I do willingly.

I curled up on the sofa, head racing with everything. I was really triggered, not sure what it was that actually set me off, but I was whole hog reliving things all over again. One memory would trigger another one, and so on. This was roughly 5am.

I didnt even hear anyone coming into the flat (I live in temporary supported accomodation). Terry, one of the staff here, touched my leg. Not having a clue I even had company being so lost in my own head, I jumped a mile out of the chair. Her touching my leg, not only scared the bejaysus out of me, but it brought me back to the here and now. A mix of my heart trying to punch its way out of my chest and the realisation that I was safe, here and not back there, I broke down into tears, which soon made its way into full blown hysterical sobs. Terry and the other staff member, the manager unfortunately, told me they would leave me be for a bit and come back in 15mins.

I managed to calm myself down, realising that if they saw me in such a state it could lead to one of 2 things. They would either make me see a doctor and they would actually realise that I am not coping as well as I pretend, or they would ask me to find alternative accommodation as I would be deemed too “high risk” or “complex needs”. Thankfully it was the lesser of the 2, and when they returned in about 10mins, they told me I needed to go see a doctor. They asked when I last ate, I told them honestly, I didnt know, and when I last lept, again, I didnt know. I was trying to look composed and together, even changing my jammie bottoms so the blood couldnt be spotted on the old ones, and had started tidying round (i.e. aimlessly picking up things and binning them) to give the impression of a together, able to cope, not so much of a mess person. I couldnt stop shaking though. When they asked me what day it was, I said Sunday, erring on the side of caution, thinking maybe Saturday. It was Monday.

Emergency doc appointment was made, and I was told that I wouldnt be able to stay the night there if I didnt go. Jackie, the manager, was concerned I “might harm myself”, so I can understand her ensuring I would go see the doc so then her back was covered. I went, accompanied by aforementioned Terry, who said she noticed the dressing on my wrist, was it bad, etc. I was just standing, chain smoking, waiting on a taxi in the heat when I had put on a heavy coat and a warm outfit given that the last time I was out and seen the weather was Friday and it was raining then, and hadnt as much as looked out the window since.

Got to the docs, saw a different GP than I normally saw. It was also a male GP; wouldn't usually see one of those. He asked what was going on, I choked, couldnt make words come out. What the fuck are you meant to say? Well, There was a bit of an incident on Wednesday night, which on top of everything else is now getting me to the stage where I am verging on catatonic, cant cope, losing time to the extent of blotting out day at a time and when I do get even a little bit of energy, I am frantically researching the most effective suicide methods within my means.

Instead, I said I was flashbacking more, nightmares worse, not sleeping well and more time was being lost than usual...the abridged “dont section me” version.

He asked about the self harm when Terry piped in about that, I told him it was fine, manageable and I could treat the cuts at home. He asked to see them then.

Fuuuuuuuuuuuuck.

Right, I am never a fan of showing people scars, cuts, etc. It is such a private thing. I would feel just as comfortable if he asked to give me a full gynae exam in front of the waiting room. I hesitated, Terry asked if she wanted me to leave, I said yes (the less of an audience the better), and showed him only the cut on my wrist, not wanting to take my trousers down and increase the humiliation further by showing thighs. He asked if I wanted the nurse to dress it, that it was too late to stitch but the nurse could maybe do something, etc, I politely declined and covered again.

He prescribed me some more chill pills and some zopiclone for sleep, asked if there was anything else he could do for me. I said thanks, and no thanks, went to leave before he asked “The Question”.

“Are you wanting to harm yourself further”

“No.”

“Do you feel as though you want to end your life”

“No.”

At this point, all the information about researched method, flying through my head, how to, how much, time intervals, notes, etc.

Who actually admits to that.  If you aren't suicidal, then you are not going to say you are.  If you are, why tell someone, surely then that would completely get in the way of you actually being able to do anything about it.

He called Terry back into the room. Still not printed off prescription, he chatted to her about...something...I barely heard it, printed off the prescription, said something about being glad he didnt have to fill out any “pink forms”, asked to see me again on Thursday, I explained I had an appointment with a different doc already on Wednesday, should I cancel, he said he didnt want to tread on anyone's toes, then, finally, he let me leave.

I avoided the “pink form” (have no idea what that is, but assuming it has something to do with the cracker factory).

Managed to eat something, and actually slept last night (thanks to chill pill/zopiclone mix).

Mentally, still a mess, but the GP actually helped. I am less of a mess.