Two huge factors in determining which type of decision will be the result of your the judgement you caste, is the decision time frame crossed with the level of emotion at the point of the choice. Simply put, quick emotional decisions make for more "F" decisions and the opposite make for more "A" decisions.
I just recently spent a week in the hospital when my wife's great aunt was stricken ill and via the E.R. was placed into the I.C.U. (and I.C.U. too). The relative is in her early nineties and does not get around easily but other than that her health is basically good. She had developed Pneumonia and was having trouble breathing and fluid was building in her lungs. When she made it to the I.C.U., they also discovered that she had a large bleeding ulcer in her stomach that required a tube to be inserted into her nose down to her stomach for drainage. She also had an infection that required an IV drip of antibiotics. She was in bad shape. When we arrived, she did not look good, so I began trying to prepare my wife for the worst. A short time later my mother-in-law arrived and the nurse then stepped into the room.
The nurse said, "Okay I was told by the doctor to wait till you got here to start the morphine drip, so I'll just start it now.
My mother-in-law then said, "Oh no your not, I know what the morphine is for (have you heard any songs by Youth In Asia?)...and it will depress her breathing so it will not be used."
The nurse, looking perplexed said, "I spoke to the doctor and he said...".
But my mother-looked-up and said, "I will not permit the morphine to be used." The nurse then went away looking puzzled.
The next day the elder care physician came in and took the position that the morphine should be used to ease my wife's great aunt's suffering because this patient would not recover and it would be cruel to allow her to continue to suffer. Again my mother-in-law said "no" and the doctor then stormed off.
Now my mother-in-law is a R.N. and had already planned for this eventuality (the relative/patient was in her early 90's after all) and had set up the parameters for the use of morphine or not, long before this day. Now the rest of the family started rolling in. One brother of my mother-in-law came in frantic and upset and decided morphine was the right thing to administer. He was followed by his sister and then the other brother and all voted for the morphine. Their decisions were made in the height of emotion and extremely quickly.
The conclusion? The elder relatives infection is now gone, her ulcer has stopped bleeding and the tube has been pulled. She is eating on her own and is now without any supplemental oxygen and will be leaving the I.C.U. any day now.
So the "A" decision was to keep her alive and the "F" decision would to have killed her with the morphine. Too short decision time frame and too high emotionally would have killed the elderly patient had my mother-in-law not had the power of attorney and made a good decision before she arrived at the hospital.
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