In my last column, I mentioned the writing of Dr Groopman, but trying to save space, I did not make his main point clear.  I am sorry for that and below is a more detailed account on what Dr Groopman wrote and how I interpreted it.  Of course, any error of interpretation is mine.

Dear Dan,

I recently divorced after many years of marriage. Splitting our assets and accounts was a long and difficult process. Now I’ve discovered that my advance medical directive still has my ex-wife listed as my healthcare proxy. Should the situation arise, she can decide whether to keep me alive or disconnect me from life support. Should I find somebody else to take over this role or wait a bit, so as not to ruffle already hurt feelings or cause further practical headaches? What if I die in the meantime?

—Alec

You should certainly keep your ex-wife as your healthcare proxy, and not simply out of convenience or a desire to avoid giving offense.

As the doctor and medical writer Jerome Groopman has observed in one of his New Yorker Columns “Sometimes, however, a doctor’s impulse to protect a patient he likes or admires can adversely affect his judgment.” Dr Groopman then continues to describe one of his own cases: “I was furious with myself. Because I liked Brad, I hadn’t wanted to add to his discomfort and had cut the examination short. Perhaps I hoped unconsciously that the cause of his fever was trivial and that I would not find evidence of an infection on his body. This tendency to make decisions based on what we wish were true is what Croskerry calls an “affective error.” In medicine, this type of error can have potentially fatal consequences.”

My interpretation of Groopman’s observation is that it is often better for doctors not to have special feelings for their patients. Why? Because as lots of research has shown that it is difficult to be objective in making decisions for people we are attached to. We make more judicious decisions regarding people we care about less.

In your case, your ex-wife doesn’t care much about you these days. And because of that, should you sustain a serious injury or illness, the odds are in your favor that she will make more rational decisions on your behalf than she would have done during the days when she loved you deeply. Even if you do end up getting remarried, keep her as your healthcare proxy. There is no substitute for the rational coldness that comes from having your ex-wife make decisions for you.

This being said, don’t tempt her too much: Make sure she is not one of the beneficiaries of your will or life insurance.