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Living Wills Can Save a Lot of Heartache

Times Staff Writer

To avoid protracted legal battles similar to the Terri Schiavo case, experts recommend discussing options and wishes for end-of-life care, and committing them to paper. Here are some things to keep in mind:

How should I specify what I want to be done if I am too sick to communicate?

For the record:

12:00 a.m. March 23, 2005 For The Record
Los Angeles Times Wednesday March 23, 2005 Home Edition Main News Part A Page 2 National Desk 0 inches; 25 words Type of Material: Correction
Schiavo’s age -- A question-and-answer article in Tuesday’s Section A said Terry Schiavo was 22 when she went into a vegetative state. She was 26.
For The Record
Los Angeles Times Thursday March 24, 2005 Home Edition Main News Part A Page 2 National Desk 1 inches; 38 words Type of Material: Correction
Terri Schiavo -- A question-and-answer article in Tuesday’s Section A stated that Terri Schiavo was 22 when she went into a vegetative state; she was 26. A correction of that error Wednesday misspelled Schiavo’s first name as Terry.

Write either a living will or instructions describing the treatment you would want if you cannot make decisions yourself, and designate durable power of attorney for healthcare to someone who will make decisions on your behalf. In California, these are combined in a single document called an advance healthcare directive.

What sort of things can I specify?

The directive can describe the quality of life you would want to maintain, or specify desires in various scenarios -- such as differentiating between a coma and a vegetative state, or forbidding use of a respirator or a feeding tube.

Will an advance directive guarantee that my wishes will be followed?

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Not necessarily. Technology can keep patients alive in situations that usually cannot be anticipated. Typically, documents may overlook many small decisions to be made along the way, such as whether a patient should get dialysis or have transfusions, and how much time should be allowed before conceding there’s no hope.

However compelling a written statement of wishes may be, any family member can contest it and start a potentially lengthy legal battle. But in the end, the medical and judicial systems nearly always uphold a patient’s written wishes.

Terri Schiavo was 22 when she went into a vegetative state. Do young people need to have such advance directives too?

It is particularly important to have an advance directive if the person who would be responsible for making the medical decisions -- called a surrogate -- does not share the same views on end-of-life issues and could have difficulty honoring them. Surrogates can be a spouse, children of adult age, or parents, in that order of legal priority, or a designated proxy older than 18.

Who needs to sign and witness it? Are any forms available?

In most states, the advance directive must be notarized and signed by at least two impartial parties. Copies should be given to family members, close friends and the person’s physician and hospital.

The directive should be incorporated into a patient’s medical chart. Hospitals are required by law to provide information about advance directives to people in their communities and to ask each patient upon admission if he or she has one, and if not, whether they want one.

Documents, which vary by state, can be obtained online:

* Partnership for Caring provides specific advance directive forms for each state at www.partnershipforcaring.org.

* Aging With Dignity offers details about getting its Five Wishes document at www.aging withdignity.org.

* Health Directives charges $18 a year to scan directive documents and make wallet-sized cards specifying how medical providers can retrieve the documents from the website at www.healthdirectives.org.

* The U.S. Living Will Registry offers directive services for member hospitals at www.us livingwillregistry.com.


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