While the family's together this Thanksgiving, talk to them about your living will — or what you want doctors to do, or not to do — if you're ever in a coma or unable to make medical decisions.
This goes for every adult at the table — not just Granddad and your great-aunt Betty. Earlier this month, a 32-year-old Indiana deer hunter chose to end life support after a fall from a tree left him paralyzed from the shoulders down. He'd recently talked to his wife about end-of-life wishes, which he confirmed by shaking his head “no” when family members asked if he wanted to live.
But you and I one day may be unable to speak for ourselves — and that's why we need written living wills, which are easy forms that can be completed without an attorney and state the limits, if any, you want to set on medical care.
A living will, or “advance directive,” includes a section on organ donation and lets you authorize a person or people to sign do-not-resuscitate orders or make other medical care decisions for you in case you become so ill that you can't do it yourself.
I've seen the need for living wills within my own circles.
Thanksgiving weekend six years ago, acute leukemia claimed my best friend, Martha, who suffered a stroke during one of her final treatments that robbed her of her speech. We hadn't yet turned 50.
And, over the last several years, I've had two friends — Jim and Kathy — who, with little warning, lost consciousness, and eventual brain activity, due to aneurysms. Their families had to make the decision to take them off life support.
The late Laura Cross, an Oklahoma City health care attorney who trumpeted living wills for decades before she herself was diagnosed with terminal ovarian cancer, once told me that many people don't sign living wills because they incorrectly believe the legal document limits their health care choices.
“But the document has no force and effect until you can't make your own decisions,” she said.
For example, Cross' advance directive specified she wanted no administration of artificial nutrition or hydration, yet at the time of our interview, she was being fed intravenously.
“Most people can make their own health care decisions until their last day or so, even people with terminal cancer,” said Cross, who died five years ago at age 63.
Cross told me some of the hardest cases involve young people involved in car wrecks who haven't made their wishes known.
Debra McCormick of McCormick & Bryan in Edmond suggests people include additional language in living wills, explaining more fully what they want to happen if faced with a prolonged and painful death.
In one recent case, a 70-year-old man who was terminally ill due to colon and bladder cancer that had metastasized to his liver wanted his doctor to disconnect his ventilator. The doctor refused and even had restraints put on the man to keep him from doing it himself, McCormick said.
After dying an agonizing and slow death, the family sued to hold the doctor accountable for refusing to follow the man's directive, she said.
A district court in Tulsa County granted summary judgment in favor of the doctor, finding him not liable for failing to follow the man's health care directive, McCormick said.
Hard to determine
The doctor claimed after the fact that he couldn't determine if the man would die within six months even with the administration of life-sustaining treatment and thus the advance directive never became operative, she said.
Weeks of pain and suffering and tens of thousands of dollars in medical care later, a different doctor allowed the man to be taken off the ventilator, not because of the man's health care directive but because the family wanted it done.
The man had attempted to do everything he could to refuse treatment, but an advance directive is worthless if a doctor refuses to follow it, she said.
“So give copies of the directive to your loved ones, your attorney and your doctors, and talk with them,” McCormick said. “But remember, an advance directive is only as effective as the people carrying it out for you. Don't wait until complications arise to discuss what you want,” she said, “because by that time, it may be too late.”
How to obtain
a living will
The legal document is free and is available under “Forms” at senior-law.org. It also can be obtained from hospitals and aging agencies. It requires two adult witnesses who aren't heirs or relatives.
Most people can make their own health care decisions until their last day or so, even people with terminal cancer.”
A late health care attorney