Best Way to Keep Control Is to Leave Instruction("essential" post-Schiavo)

[DeepModem Mom]

The Best Way to Keep Control Is to Leave Instructions
By DENISE GRADY

Published: March 29, 2005


....the Schiavo case has sparked new interest. Orders for living wills have shot up to 2,000 to 3,000 a day, from fewer than 100, said a spokesman for Aging With Dignity (www.agingwithdignity.org or 888-594-7437), a nonprofit group that provides the documents for $5. Another group, the National Hospice and Palliative Care Organization (www.nhpco.org or 703-837-1500), which gives away the forms, also said the requests had increased. Dr. Arthur Caplan, the director of the center for bioethics at the University of Pennsylvania, said: "It used to be important to have a living will. Post-Schiavo, it's become essential to have a living will."

Living wills describe a person's wishes regarding treatment. Another type of document, called a health care power of attorney or health care proxy, names someone else, usually a relative or a friend, to make decisions when a patient can no longer do so.

Such written instructions, also called advance directives, can be used in every state. They are backed by either law or precedents set in court cases, and a federal law requires that hospitals and nursing homes inform patients that they have the right to fill out the documents. Details vary from state to state; in some places no official form is needed, and patients can draw up their own statements. Two witnesses are usually needed. The details should be discussed with family members and doctors, who should also be given copies. A copy should also be included in the medical chart if the person is hospitalized....

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A Web site for a nonprofit group, www.medicaldirective.org, offers documents for $15 along with detailed work sheets describing possible medical situations for patients and families to consider.

But it is nearly impossible to anticipate every situation that will arise during an illness. Therefore, some experts say it is more important to have a proxy than a living will, someone who knows the patient and can make decisions if the unexpected occurs. Picking a backup proxy is also recommended. But patients must discuss their wishes in detail with proxies, and make sure that doctors and relatives know who the proxy is. Dr. Caplan suggested bringing up the subject at family gatherings....


http://www.nytimes.com/2005/03/29/health/29cons.html