“I want you to know that it occurs to me now.

That is the only thing I have to offer you and it is not enough and I know it isn’t.”

Part Eighteen: What Changed

Here is what came out of eleven pages and ninety minutes, and it is small, and it is real, and it is the only thing in this account that can be described as a result.

The health system changed one line in its policy on surrogate decision-making for life-sustaining treatment.

The new line says that where a decision to withhold or withdraw life-sustaining treatment is being made by a surrogate, and another person who would rank equally or above that surrogate in the statutory hierarchy is a patient in the same facility, a member of the care team shall independently verify that person’s documented capacity, and shall record the verification.