Moral, ethical, religious, and humanitarian issues notwithstanding, I’m sure that all of us would like to spare our loved ones the agony that was visited on the Schiavos. The way to do that is to make it both clear and legal, in writing and in front of competent witnesses, what our desires would be in the event we are enmeshed in similar circumstances. If Terri had done that, instead of communicating only verbally with her husband, fifteen years of other people’s agony could have been avoided.
Dr. Barry Baines is associate medical director for Hospice of the Twin Cities, and the author of Ethical Wills: Putting Your Values On Paper. Here is the gist of a conversation he had with Michele Norris, of National Public Radio, on the subject of “living wills.”
A living will (or “advance care plan” or “health directive”) is a written, signed, witnessed and notarized set of instructions that details the kind of medical interventions you want–and do not want–to receive in the event that you become unconscious, terminally ill or otherwise unable to speak for yourself.
Most living wills are accompanied by another document, executed at the same time, called “durable power of attorney for health care decisions,” “health care proxy,” health care surrogate,” or similar name, depending on the state in which it is executed. This document designates someone, usually a spouse or child, who will make decisions for you if you become incapacitated. It is important to talk your wishes over with your proxy in some detail, so that they will be able to carry them out if necessary. It is also a good idea to make such arrangements a part of your medical records with your primary care physician, and with any specialists you may consult.
An “ethical will” is a way to record and share your values, hopes, beliefs and life lessons with your family, friends and community. It can help identify things that are important to you, and can make it easier to complete a living will. It is not a legal document. Think of it as a list of everything you would like to pass on to others.
Depending on the state where you live, rules for living wills may vary. Some states allow the medical directives and power of attorney to be on one form, while others require that they be separate documents, (Florida, for instance.) Laws also differ on who can sign as a witness, and on how many witnesses are required. Many states do not require a lawyer to write a living will, but it is a good idea to check carefully the laws in your state.
Regardless of our state of health, we owe it to our loved ones (and ourselves) to avoid the horror of a situation such as Terri Schiavo’s. Terri was only 25 when her accident took away her ability to make decisions for herself.
Parenthetically, I would point out that if you believe your family might not agree with your wishes, a living will and carefully-chosen health care surrogate become even more important.
The National Hospice and Palliative Care Organization, which represents hospice professionals, offers free, state-specific living will forms through their Web site at http://tinyurl.com/66ryv .