Advance Health Care Directives Can Prevent a World of Pain

By Robert J. Grey Jr., President,
American Bar Association

By now, we’ve all seen the excruciating images of Terri Schiavo and witnessed the anguish that her parents and husband are experiencing as they struggle with the ramifications of Terri’s condition. What too many of us are not aware of, however, is that a single piece of paper could have helped prevent this controversy.

Had Terri Schiavo prepared an advance health care directive outlining who she wanted making decisions on her behalf and how she wanted to be cared for, the battle over her care could have been avoided. Unfortunately, she left no written directions, leaving her parents and husband to argue her fate in the courts. Even more unfortunate is the fact that she has plenty of company.

According to a study published in 2002, just 15 to 20 percent of Americans have signed living wills, durable powers of attorney, advance health care directives or other documents outlining their intentions and desires. As a result, too many families are forced to make wrenching decisions about loved ones without proper guidance. Worse still are the cases in which elderly patients are rendered incapable of making health care decisions, but have no family members to help, leaving the decisions to caregivers.

Fortunately, these terrible situations can be avoided. By taking the time to appoint a health care proxy, make our desires known, and put them in writing, we can spare our family members and caregivers a great deal of anguish.

That is why the American Bar Association is committed to encouraging competent adults to take the time to complete advance care plans stipulating who should make decisions in the event they should become unable to speak for themselves, and what their basic health care preferences are. As part of that effort, the ABA has made available a wide variety of free on-line resources designed to make it easier for people to make the necessary preparations. Those resources, which can be found at www.ABALawInfo.com, include forms and information available to the public for download free of charge.

The ABA is also supporting a bill called the Advance Directives Improvement and Education Act of 2005. Introduced by Senator Bill Nelson of Florida, the bill would help ensure that every adult’s health care wishes are known and respected by his or her physician and other health care providers, both within their home state and across state lines. It would also direct funds to the Department of Health and Human Services to conduct public education on advance directives, and would provide all Medicare beneficiaries access to physician consultation and advice when preparing their advance directives.

Without question, these are difficult conversations to have. No one wants to envision a day in which they, their spouse, or a parent is in such a medical condition that they cannot make decisions for themselves. But whether you’re old or young, healthy or ill, it’s never too early to start thinking about who you want making decisions for you in an emergency, how you would want key health care decisions handled, and what your basic desires are.

The Advance Directives Improvement and Education Act and the ABA’s online advanced planning resources are designed to make it as easy as possible to do so.