• August 27, 2014

Right-to-die case sheds light on need for directives

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Posted: Sunday, March 27, 2005 12:00 pm | Updated: 3:14 pm, Wed Aug 15, 2012.

By Judy Pack

Killeen Daily Herald

The media spotlight on the legal battle between Terri Schiavos family members to disconnect the feeding tube that has kept the brain-damaged woman alive has served to make millions of Americans address their own fate.

Terri Schiavo is only 41 years old and has no living will in place to guarantee that her wishes regarding artificial life-sustaining procedures would be honored.

According to Texas Attorney General Gregg Abbotts office, the most common cause of death for young people between the ages of one and 44 is trauma such as motor vehicle accidents, homicide, suicide and drownings. These deaths involve difficult end-of-life decisions, and very few victims have living wills in place to guide family members in making those decisions.

The topic is too morbid, said Christina Gindratt, staff attorney for Legal Aid in Belton. Young people are going to live forever, and no one wants to talk about it. Living wills are important so that your wishes and your desires are known.

While Florida law differs from Texas law, Gindratt said that if Terri Schiavos wishes regarding life support had been written down, the family would not be in the current legal battle.

Schiavo has been in a vegetative state since her heart stopped because of a chemical imbalance in 1990. She can breathe on her own, but has been dependent on a feeding tube and, according to doctors, is in a permanent vegetative state with no hope of recovery.

Gindratt pointed out that the key issue is that an individual never knows when an accident or an incident resulting in difficult decisions is going to occur, and the directive is for your physician, your parents and any other family members.

There are two conditions under which a living will can be applied, she said.

Irreversible illnesses such as Alzheimers disease or cancer, and terminal diseases. You may not be terminal and can make decisions for yourself. A living will is used when death is imminent and you cannot speak for yourself.

Gindratt said there are a number of ways to get a living will, including contacting any area hospital. Several Web sites have the form available, including the State Bar of Texas at www.txbar.com and the Texas Young Lawyers Association at www.tyla.org. The attorney general of Texas has detailed information in addition to the document at www.oag.state.tx.us.

The always preferred method is to go to an attorney, especially for older individuals, she said.

It is difficult to think about dying. If they have Alzheimers disease, they will want to get this done while they are still competent to make decisions.

Legal Aid also prepares living wills as long as the person meets the requirements for the service. Anyone interested in inquiring about Legal Aid may call the Intake Hotline at 1-800-234-6606.

Once the document has been completed, a copy should be given to your physician and to family members. The directive should be kept in a safe place, but where someone else has access to it, Gindratt said. Placing it in a safe deposit box is not a good idea.

Local attorney Gene Silverblatt says people should do their planning in good times, so no one has to mess with it in bad times.

It is a directive to physicians, not a living will, actually, he said. We have a statutory form in Texas where you have a place to indicate if you want life support or not.

Although Silverblatts legal practice specializes in estate planning, he said the issues involved in a directive need to be discussed with clergy, family members and a physician.

A medical power of attorney is another legal document that is essential for everyone to complete.

If a person is unable to make health care decisions including the right to die, such as a stroke, a medical power of attorney names the person with authority to make the medical decisions on behalf of that person.

There is some overlap of the two, Silverblatt said. My wife knows my wishes at death. A directive to the physician is expressing my wishes (regarding life-sustaining treatment). It removes the guilt.

When the wishes of the patient regarding such measures are not in writing, he said, problems can arise.

Silverblatt also advises that someone know where your directive is kept and that your physician have a copy.

I have mine in PDF format, he said. I want medical personnel to be able to put it in a computer and pull up my entire medical records and directive, for the more technically oriented.

He also has a Web page that provides information on directives to physicians at www.silverblatt.com.

Leah Snell, who works as a licensed clinical social worker at Metroplex Hospital in Killeen, said they have the directive forms available for anyone.

We will occasionally have someone come into the office and say they need the directive to the physician, she said. We can explain it to them, and if they are ready to complete it, we use our volunteers as witnesses. It does not require a notary public.

Snell said she hasnt noticed an increase in the number of people asking for the directive, although she would welcome it.

Most of the people who request the form through their office have someone in the hospital, or have had, and realize they need to have their wishes in writing, she said.

She can also provide summary sheets to use in guiding the person through the decision process. Their office also has medical power of attorney documents, she said.

We keep a copy of their directive for our medical records department and advise that they give copies to their doctor and their family, she said. If they come to our emergency room, having a copy in our files may save some trouble.

Information about directives is also available from the Office of the Attorney General, P.O. Box 12548, Austin, TX 78711-2548, or by telephone through the Elder Law and Public Health Division at 1-800-806-2092.

Contact Judy Pack at jpack@kdhnews.com

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