Schiavo case sheds light on living wills

SIKESTON - No matter what people's opinions concerning the Terri Schiavo situation, they should learn an important lesson - the importance of documenting their intentions for health care should they be unable to speak on their own behalf.

The family of Schiavo, a brain-damaged women in Florida, is fighting over whether to reinsert the feeding tube she has been hooked up to since suffering brain damage in 1990. Her husband argues that she would not want to be kept alive artificially, while her parents disagree.

"It is the best evidence of somebody's intent because it is written," said Joe Blanton, member of Blanton, Rice, Sidwell, Nickell, Cozean and Collins, L.L.C.

Brian Smith, director of pastoral services at Missouri Delta Medical Center, is in charge of the living wills and advanced directives for the hospital. He agreed.

"It is a lot like insurance," he said. "It's something we don't plan on using, but if we ever do need it, we're grateful that it's there."

Lawyers also tend to encourage these plans to all of their clients, especially those who have done or are in the process of doing estate planning. Sometimes referred to as 'living wills' the name can be deceiving.

"It has nothing to do with money or possessions," he said. "It just has to deal with an end of life decision."

The modern version of these plans are typically referred to as medical health directives. "These are documents where you give a directive on your medical care and how you want it handled," said Pete Burns of Burns and Taylor L.L.C.

He and Blanton recommend the Durable Power of Attorney for Health Care and Health Care Directive. This form can be obtained for free online at www.mobar.org.

The form is self-explanatory and is not required to be filled out by a lawyer. Some lawyers do not charge for this service, and Missouri Delta helps community members fill out the forms for free.

Filling out this form can be beneficial in two ways, according to Blanton. "First, it allows a person to express his or her intent if they so choose not to be kept alive artificially," he said.

Secondly, it allows persons to designate someone else to make their decisions for them. "That is a much more likely scenario," Blanton said. "Most aren't like Terri Schiavo."

Someone who is appointed to make decisions concerning health care for another must be at least 18 years of age. They are also only allowed to act if the affected person is unable to communicate or has no hope of recovery, according to Smith.

Just because someone has signed a directive does not mean they won't receive proper care. "If they see that you can be saved, the doctor will do something," Smith assured.

Procedures concerning these directives vary from state to state. According to Burns, Missouri has some of the best policies. This is partially because of the Supreme Court ruling in the case of Nancy Cruzan, he said. Cruzan was thrown from her car in a Missouri accident and suffered brain damage at age 25. In 1990, the Court's decision allowed Cruzan's parents to prove she did not want to live in a "vegetative state."

The recent attention to the Schiavo case has once again made these directives a priority to people across the nation. "I've had several people in the last couple of days who have called my office and wanted to have them done," said Smith. "That's the silver lining in a case like this - it makes the public more aware of the need."

So when should someone consider filling out one of these directives to document their intentions?

"We encourage people of all ages," Burns said. "You never know, you see more and more young people having strokes and there's always the potential for an automobile accident." For this reason, he, Blanton and Smith have helped people of all ages fill out the directives, not just the sick or elderly.

The only requirements to filling out a form are being 18 years of age and being of clear and sound mind for more than 24 hours. "This means being fully aware and responsive of what's going on around them," Smith explained.

Copies of the form should be shared with the person designated to make decisions, the family doctor and family members. Hospitals also ask the family to bring a copy of any health care directives when a patient is admitted, since they are required by law to have a copy on hand before withholding any treatment.

Although he has never had a situation like that in the Schiavo family, Smith has experienced times where a decision had to be made. "Most of the time the families unified and dealt with the decision; they usually do what they think the patient would think," he said.

He added that a living will makes this type of situation easier and may take away guilt a family may have for withholding certain types of treatment. Burns agreed, adding, "this can be pain free, it's not where you spend a lot of money to express your intentions."