Put It in Writing

Put It in Writing

Schiavo case underscores need for documenting health-care decisions.

The recent Terri Schiavo case underscores “the importance of everybody 18 and older having a healthcare power of attorney and having these discussions with their immediate family members,” said Jerry Gimmel, a Gaithersburg attorney with the firm Gimmel, Weiman, Ersek, and Blomberg, who is an expert in wills, estate planning, and elder law.

Gimmel and others said that two documents — living wills and healthcare powers of attorney — work in tandem to help meet a patient’s wishes.

Living wills set forth specific directions on how much and what kind of care to administer to patients in a terminal state, end state, or persistent vegetative state.

A healthcare power of attorney designates an agent, usually a spouse or other family member, who will be authorized to make all treatment decisions for an individual should he be unable to communicate his wishes.

“We advocate that the health care power of attorney is far superior to the living will, because you don’t have to be terminal, because you can evaluate the situation at the time that it occurs … and because you have your family members making these kinds of decisions instead of some health care professional you may have never met,” Gimmel said.

“It can be as broad or as narrow as one wants, but it should be given to someone you have total confidence, who knows what you want and will do what you want,” said Fred Goldman, a Potomac attorney who specializes in estate planning and elder law. “Circumstances change. Someone might do a living will or a healthcare power of attorney and medical technology changes, what have you, and someone has that healthcare power of attorney, they should have broad powers. They should know what you want, but also have authority if need be to make judgments based on those [wishes.]”

National statistics show that the majority of adults do not have such documents.

Gimmel pointed out that Schiavo was 26 when she had her debilitating heart attack and that a similar case in Maryland concerned Ronald Mack, who was seriously hurt in a car accident at age 19.

“Age is no respecter of these things at all,” he said.

TEMPLATE LIVING WILLS and powers of attorney are available for free or for minimal cost from numerous sources such as the office of the Maryland Attorney General and non-profit organizations like Aging with Dignity.

More sophisticated documents are typically drafted by attorneys.

Del. Marilyn Goldwater (D-15) chairs the long-term care subcommittee of the Health and Government Operations Committee in the Maryland House of Delegates. She said that the Schiavo case poses dilemmas that should be addressed individually rather than through legislation.

“These issues come into being because people bring it to us. I sometimes wonder whether that is an appropriate role for government in terms of dying," Goldwater said. “It’s a very personal thing, and everybody has their own beliefs and their opinions.”

Goldwater suffers from an incurable blood disorder called multiple myeloma. She highlighted not only the importance of having a living will and a healthcare power of attorney but of regularly updating them

“Even as a legislator, it doesn’t always register in my mind, ‘Oh this change means something for my living will,’” but she and her husband review their documents and their personal wishes regularly.

Goldman agreed. “It’s a difficult enough circumstance to be in that position to have to make those decisions. But if the healthcare provider or the banker or the broker looks at one of these documents that’s 10 years old and says, ‘How do I know this is still valid?’ it just becomes that much more of a burden at a time when you don’t want to be.”

“Even though it’s not a subject you want to think about I think once you’ve done it you feel better,” Goldwater said. “It saves a lot of heartache.”