November 21, 2009



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The Will to Die

By Karen Hube, July & August 2005

His family disagrees about end-of-life care. How can he make sure he won’t be the next Terri Schiavo?




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Brian Linten, 66, of Austin, Texas, who suffers from Lou Gehrig's disease, has a living will, an official document that details what kind of medical treatment he wants—and doesn't want—should he become unable to communicate. But when he and his family were discussing the recent Terri Schiavo case—in which a brain-damaged woman's family members disagreed over whether to detach her feeding tube—his son declared that he could never stand by and watch his father die if there was a way to keep him alive. That got Brian to thinking: is there any way he can make sure his living will will be honored?

Brian is smart to ask that question. "A lot of living wills don't work because people don't formulate well-thought-out wishes," says Carl Schneider, a law professor and bioethics specialist at the University of Michigan. They also don't write them down clearly or anticipate how complicated a situation can become, he adds. No living will is ironclad, but here's what you can do to be (reasonably) confident that your doctor, friends, and family will honor your last wishes.

Make a Record

Write down in clear language exactly what kinds of medical treatment you want or don't want, so there is no room for misinterpretation, says Paul Malley, president of Aging With Dignity (888-594-7437), a nonprofit group that helps families with end-of-life issues. Many living wills use the term "life-support treatments" without detail. "Life support could include everything from a respirator to artificial nutrition and hydration," Malley says. "Be specific." A living will should also address whether or not you would like to receive pain medication.

Appoint a Guardian Angel

You'll need a health-care agent, who will be legally responsible for carrying out your wishes. Choose a family member or friend you trust, as well as a backup agent in case your first choice dies before you do. Make sure the people you choose are well-informed about your wishes and strong-willed enough to carry them out in the face of opposition from family members. To ensure that your agent has legal authority to make decisions on your behalf, fill out a form for durable power of attorney for health care, which you can get through your doctor's office or a hospital.

Speak Up

Discuss your wishes with your family and close friends and also give them (and your health-care agent) copies of your living will. That way they know you have thought about this lucidly, in advance of any physical or mental decline.

Follow the Rules

In many states, the living will and durable power of attorney for health care—known as "advance directives"—are combined in one form. Almost every state has suggested forms to use that you can get through your doctor's office or local hospital. You can also download free state-specific forms from Caring Connections (800-658-8898). And the AARP Foundation offers free booklets titled "Planning for Incapacity," which are tailored to each state and include all necessary forms. Call 202-434-2118 for more information.

Karen Hube is a financial reporter in Westport, Connecticut.

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