Here is #3 of our 4 part "Back to School" series. This is a very "hot" topic. Let me know if you have anything to say on the subject!

Living Wills and Health Care Surrogates

 
Over the last several years, it has been hard to avoid hearing about the Terri Schiavo case. Though many of us would prefer to avoid it, an article in the newspaper just recently said that the Schiavo case has increased awareness regarding the importance of living wills. It has, no doubt, increased awareness---but will it really motivate people to actually sign living wills? Are you going to sign a living will now?

A living will is an expression of your wishes regarding end-of-life decisions. If you don't want to be kept alive artificially, should you be terminally ill or in a vegetative state, you should sign a living will making your wishes clear. For a doctor to withhold or withdraw artificial life sustaining treatment, the law says there has to be clear and convincing evidence that those are the patient's wishes. The best way to accomplish this, of course, is to put your wishes in writing by signing a living will. As we know, Terri Schiavo didn't do this. Her husband says that before Terri became ill, they had discussed these issues and Terri had made it clear she wouldn't have wanted to be kept alive in her condition. Her parents disagreed. Terri was kept alive for 15 years.

I work with the elderly and their families every day. Because these end-of-life issues are on so many peoples' minds, we all have the opportunity to educate the individuals we serve on these issues and empower them with the knowledge they need to make informed decisions. It is important for everyone to realize that a living will can be tailored to suit their wishes. IT IS NOT AND SHOULD NOT BE A STANDARD "FORM". For example, some may not want their lives prolonged in any way should they be terminally ill and unconscious, while others may want all means possible used to keep them alive. Still others may wish to decline all life prolonging treatment with the exception of food and water. Often religious customs and preferences effect how we draft these documents. Choice of who the trustee is should be discussed with the attorney.

Regardless of your decision, it is critical that you discuss your wishes with your family members and loved ones. While a living will is clear and convincing evidence of a person's wishes, it is possible that from a practical standpoint in a true end-of-life situation, the document's strength might be diminished if parents, children, or spouses claim the living will does not reflect their loved one's wishes. This could also happen if close family members simply don't agree with each other on whether or not the living will reflects their loved one's wishes. You can imagine the concerns a doctor is going to have when a patient's living will says she doesn't want to be kept alive artificially but the patient's daughter is there pleading with the doctor to keep her mother alive---saying that she knows her mother would have wanted to live. You must discuss your wishes with your loved ones. And again, you must name your most trusted person to make these decisions.

In our office we include the living will in our Health Care Surrogate (also called a Health Care Power of Attorney) This is a document that designates another person to make any health care decisions for you if you are unable to make them yourself. A doctor must determine your incapacity before the surrogate can act.

Sometimes these provisions are included in a Durable Power of Attorney but should really be a separate document dedicated to health care so that it can be more comprehensive.

The key is to act now. You may want to begin by contacting our office to discuss questions you have about living wills and health care surrogates. Once you've been educated about your options, you can make the decision that's right for you. And once your decision is made and you have acted on it, you can take the next step of discussing your wishes with your family. Our office takes a holistic approach to serving our clients and can help you with this part of the process as well.