Monday, August 3, 2009

Living Will and Healthcare Reform


Remember, the 2005 Terri Schiavo case which received national attention. Living Wills, an estate planning document, received front page notoriety and was the topic of discussion around water coolers, coffee shops, chat rooms, you get the picture. It was all a buzz!!

Well, it's back!! This time Living Wills are being discussed in the context of healthcare reform. Doctors and medical institutions in the past had been encouraged to determine the medical treatment wishes of their patients. Have you or someone you love been to the hospital recently? What are all those forms that you have to fill out? For many medical procedures, the hospital wants to know your preference regarding any life support measures or whether you want to be resuscitated. They may ask do you have a Living Will or DNR (do not resuscitate) order.

As I have counseled my clients,a Living Will is not the same as euthanasia. However, this has become part of the current controversy. So I think it is important to discuss exactly what a Living Will is.

What is a Living Will?
In the context of laws like Pennsylvania, a Living Will is used to express your desires regarding life support for end-stage medical conditions or a permanently unconscious state, such as an irreversible coma or an irreversible vegetative state. There also has to be NO realistic hope of recovery. In other words, without life-support, death would result. Your physician and generally another attending physician would make this determination. After the determination, the surrogate named in your Living Will would express your wishes as documented.

What are Life Support Measures?
The type of life support addressed by your Living Will may include measures like mechanical respiration, cardiac resuscitation, tube feeding, or other artificial forms of nutrition or hydration. This is not an exhaustive list but merely serves as an example. With modern technology, the forms of life support continue to advance. That is why it is important to have a discussion with your physician to understand the options available and how you want to address those options.

Do You Have A Living Will?
A year after the Schiavo case brought national attention to the subject of Living Wills and people were being encouraged to express their wishes in a Living Will, I commissioned a survey and found that 69% of the local population still DID NOT have a Living Will. Age did not matter, though the older population was slightly more prone to address this topic than those much younger. The results of the survey confirmed that most people are not making Living Wills a priority. Even with the incredible media coverage surrounding the case many people just have not been moved to action by executing a Living Will. I surmised, at that time, that any increase in other parts of the region or nation was minimal.

What Next?
What will the current debate on Living Wills have on people? Will making a Living Will be on the rise, decline or remain the same. Well, I am looking forward to conducting another survey after this controversy ends.

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