Op-Ed: Health Care Advance Planning - The Discussion That Can't Wait

Ronald M. Davis, President, American Medical Association, and
William H. Neukom, President, American Bar Association

At some time, we will all face gut wrenching end-of-life decisions for ourselves or a loved one.  Confusion about what medical choices to make during a time when it is difficult or impossible to communicate can make an already challenging situation worse.

No one likes to look death in the eye, but making end-of-life decisions before they are needed can help you prepare for a worst case scenario.  That’s where National Healthcare Decisions Day comes in.  This year the American Bar Association and the American Medical Association have teamed up with more than 50 national groups and local organizations to support the first ever National Healthcare Decisions Day on April 16.  The goal is to engage and educate the public about the necessity of advance care planning.

While a living will may be the first thing that comes to mind when thinking of advance planning, it is in fact so much more than securing legal documents. Advance care planning is about thinking, talking and preparing, so that health decisions are made in a manner consistent with your desires.  These discussions cannot wait until a health crisis.

If advance care planning is taken seriously and properly communicated, a proxy will have the legal authority needed to oversee end-of-life care decisions.  This will allow physicians to provide the best possible treatment consistent with your wishes.  Advance care planning will also give loved ones the proper guidance they need when making difficult decisions about end-of-life care.

We urge you to ask yourself:  Who will speak on your behalf?  Whether you are 16 or 76, accidents and sudden illness can happen at any age.  Unless legal authority is given to a proxy, we leave ourselves and our families open to the kind of tragic dispute that propelled the Terri Schiavo case into the courts and into the headlines.

You should determine your own beliefs or values and preferences so that a proxy, physicians and other caregivers can respect your choices when making any healthcare decisions.  

There are a wide variety of advance care planning resources available, including forms, workbooks and communication tools.  Every state has standardized legal forms in circulation for purposes of appointing a proxy.  Review any forms carefully, as not every form or resource will be ideal for everyone’s personal beliefs, medical needs and preferences.  Physicians can also be valuable resources for their patients when discussing end-of-life preferences.  To locate helpful resources or to find a National Healthcare Decisions Day program in your community, go to www.nationalhealthcaredecisionsday.org.

Unfortunately, most people don’t express their preferences for end-of-life care and then it’s too late to abide by their wishes.  As the population ages and technologies for sustaining life continue to evolve, discussions about what kind of care we desire at the end of life are increasingly important.  National Healthcare Decisions Day is a good time to address end-of-life issues with your loved ones.  End-of-life issues are difficult to think about and even more challenging to discuss, but the best time to do so is when you are healthy. 

Take time on April 16 to think about what you want, research the options and talk to your loved ones.  The time is now, before it’s too late.

April 15, 2008