END OF LIFE DECISION MAKING

One award that I do not covet is to become the World’s Oldest Living Person. That job usually only lasts for a couple of days, and then the first runner up brushes your ashes aside and gets to wear that fancy sash. I recently agreed to have a medical procedure as a part of my semi-annual (every four to seven years, unless I can postpone it a little while) physical. I am part of that large group of older males, who try to stay out of doctors’ offices. It is funny, though, when I need one, I am like a dehydrated man at a well. I soak up all of the tests so I can be pronounced healthy.

When I went up to the desk to sign in, I was asked if I had a living will. Now, I write about a thousand living wills every year for clients, and I do in fact have one of my own. But, I will not take it to the medical office with me because it is not needed when you check in. It may be needed later if everything that can go wrong goes wrong, and it becomes time for me to “check out.”

You see, a living will only takes effect when I can no longer accept or decline medical care or treatment, due to my becoming incapacitated, being in a coma or a persistent vegetative state, or having a terminal condition. Since I walked into the place and spoke to the young lady, I was none of the above. But, what would have happened if something went wrong during my procedure, such as a reaction to medicine, or some mistake being made that caused me to enter one of those areas detailed above from which there may not be any hope for recovery. Now, when I really need the living will, where is it and who knows about it? Who have I appointed, and are they ready to undertake (bad pun, sorry) the task?

In 1992, Pennsylvania decided to join the rest of the country by enacting a law recognizing living wills. Perhaps you recall the newsworthy cases leading up to that, Karen Ann Quinlan (1976, NJ), and Nancy Cruzan (1990, MO). And certainly we all still recall the more recent case of Terri Schiavo, which dragged its way through the Florida courts from 1998 until 2005, including four trips to the US Supreme Court.

These family tragedies focused the nation’s attention on the subject of “end-of-life” decisions, and who could make them. Asking a court of law to consider the concept of the continuation of life or the cessation of life is as fundamental as a legal case can be. And, resolving the functions of the family, next of kin, physicians, and other health care providers gets to the core of life versus death.

As these cases continue to arise around the country, with specific fact situations surrounding each one, the states have tried to enact laws that give its citizens the opportunity to contribute to their own end-of-life decisions. By carefully considering your options and making reasoned decisions well in advance of the need to do so, you can help your family and your medical providers deal with your particular situation when it arises. It also removes the crushing weight of guilt that your agent will have as he or she makes these decisions for you and says the words you have written for him or her to the doctors and nurses, and also to the rest of the family. Knowing that “you would have wanted it this way” doesn’t make it any easier to deal with at the time, but it certainly makes it easier to live with over time.

This space does not permit an extensive review of the law, due to the vast number of issues that this area generates. But, there are a few places that you can go to read and educate yourself about it. One is to look at the Pennsylvania Medical Society’s patient information website, www.myfamilywellness.org. Another is to go to a search engine such as Google and type in the phrase pahealthcaredecisionmaking. There is an awful lot of content there, and you really ought to invest some time with an attorney before you sign one of these documents. You can have a few of the potential twists and turns explained to you in plain words.

The best thing is to put something down in writing, and to do it while you are vertical. Once you become horizontal, your ability to make reasoned decisions about your future gets a little hazy. Go see your friendly, neighborhood estate-planning attorney and get the real scoop. It is not too expensive (usually less that $50), and it can give you and your loved ones a great sense of relief during difficult and unpredictable times.

Christopher M. Abernethy has been practicing law in Hampton Township since 1976. He focuses on elder law, which includes wills, trusts, powers of attorney, living wills, and probate matters. He also is proficient in all aspects of real estate law and business law. He is a member of the National Association of Elder Law Attorneys, and the AARP Legal Services Network. He can be reached at 412-486-6624 or by email at cabernethy@aaylaw.com.