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Both my parents and I are doctors in India, and my sister and I have for some years been in a situation similar to yours (if not the exact same situation) with regard to not being told our parents' actual wishes in case of some unforeseen health crisis. Moreover we have seen our patients struggle with this problem when one or both parents are suddenly struck down with illness or injury.

Unlike in some other countries, Indian medical practice naturally allows close family members to make health care decisions on behalf of critically ill patients without needing special authorization. Both parents becoming simultaneously incapacitated is a rare but very possible event. And age has not much to do with it.

A man in his fifties whom we had treated for a minor illness a few years ago died recently in hospital of a sudden heart ailment and his wife passed away within 2 days of a brain hemorrhage. Their two young daughters aged 24 and 20 were abruptly in the position of needing to take vital medical decisions on their parents' behalf and had been given no instructions about their parents' wishes, although that didn't affect the outcome of those tragic cases.

The problem, of course, is our parents' extreme discomfort with discussing their own mortality with their children, which is entirely understandable in context, as pointed out by at least two earlier answers. It is the toughest and most unpleasant thing for families to discuss and most parents including mine prefer not to go into such a discussion. So I have often been anxious about what decisions I and my 2-years-younger sister might have to take in such a situation. Not to shy away from alarming and unpleasant possibilities, this is what I could understand by reviewing the problem:

  1. It is rare for both parents to be seriously ill and incapable of taking medical decisions at the same time. It is generally much more likely in our clinical experience that one parent falls critically ill and health care decisions are taken by the other parent in consultation with their adult offspring.

  2. As it is supposed to be a joint decision to be taken by siblings, each will need to consider the others' points of view if a future decision needs to be taken, and each would thus have only 1/2 or 1/3 responsibility for such decision-making.

  3. By giving multiple children joint responsibility to make future decisions (assuming in your case that you do not have any higher responsibility as the eldest child: or else please edit question to clarify) parents are actually reducing the decision-making burden of any one family member.

  4. It would certainly be more useful for parents to make their wishes explicit, but we can't make them do it, especially if neither of them is currently diagnosed with a life-threatening illness.

Since your father is currently unwilling to discuss this delicate matter, it might be counterproductive to bring up the topic with him repeatedly at present. I would advise you to try and bring up the matter with your mother instead. She might be more communicative and might also illuminate you about what your father is thinking. You might also discuss the matter with your 2 brothers independently or together to learn what they feel about taking such sensitive decisions in future.

I think your father will become more willing to discuss the particulars of this topic with you in future, after he comes to terms with the implications of your parents' difficult but correct decision to entrust you 3 siblings the future joint responsibility of their health care, in the particular case where they are both unable to decide for themselves. Since your parents are both relatively young and healthy now, it is to be seen as a currently hypothetical long-term contingency planning for the future and you can expect both parents to communicate their wishes much more explicitly to you based on more specific future health events.

English Student
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