Why You Need a Living Will

Like many Americans, you may not have given a lot of thought to what might happen to you in a medical emergency. It’s not a subject most of us want to think about, since it forces us to consider our own mortality and decide what measures we would or would not want taken to keep us alive.

If you’ve considered it at all, you might assume your family will know what you would want. Or maybe you think you don’t need to worry about making these decisions until you are much older. The tragic cases of two young woman, 30 years apart, show otherwise.

Karen Ann Quinlan

In 1975, a 21-year-old woman named Karen Ann Quinlan fell into a coma after mixing alcohol and Valium at a party. Doctors told her parents she was in a persistent vegetative state and would never recover. The Quinlans decided to remove the life support systems keeping their daughter’s body alive, but discovered they had to petition the court to do so. Over a year and several appeals later, the New Jersey Supreme Court gave Karen Ann’s family permission to remove the ventilator. Although Karen Ann continued breathing on her own, she remained in a vegetative state for nine more years before dying of pneumonia in 1985.

Terri Schiavo

Thirty years later, another young woman was at the center of a national debate about who should be allowed to make medical decisions for a patient who could not decide for herself. Terri Schiavo was 26 when she had a heart attack and suffered irreversible brain damage due to lack of oxygen. Terri’s husband argued that Terri would not want “extraordinary measures” keeping her alive; Florida courts agreed that as next-of-kin, Michael Schiavo had the right to have his wife removed from life support systems. However, Terri’s parents did not agree and challenged the case in court, leading to legal battles that persisted over a decade. Michael Schiavo eventually prevailed and Terri died after her feeding tube was removed in March 2005.

Their Legacy

Karen Ann Quinlan’s case paved the way for the establishment of advance directives, commonly known as “living wills.”  Terri Schiavo did not have a living will, the lack of which meant her husband and her parents had no way to prove what each party believed about what her wishes regarding her medical care would have been.

Only about 40 percent of Americans have living wills. Even when the document does exist, if you have not made your doctors and family members aware of it, it may not have any practical impact. Someone has to be aware of your wishes in order for them to be carried out. One positive outcome of Terri Schiavo’s tragic situation was that public awareness in living wills was raised; another was that some states clarified laws on advance directives and who has the right to make medical decisions for incapacitated patients.

The Importance of Living Wills

These two cases are extreme, but both show why it is so important for every adult to have a living will. This document outlines your wishes regarding medical care in the event you cannot communicate directly, due to severe injury or illness. In a living will, you can specify exactly what medical treatments you would accept or refuse in various circumstances.

Another benefit of advance directives: you can name a health care proxy — someone who has power of attorney and can make medical decisions on your behalf. One recent study showed nearly 30 percent of elderly patients needed to rely on someone else to make critical medical decisions before their death. Consider your family; do you want to decide now who gets to make the call, or let them figure it out themselves?

Where to Start

A living will is an important document, but preparing one doesn’t have to be complicated. Each state has its own laws regarding living wills and medical proxies, and state-specific forms are available from websites such as the National Hospice and Palliative Care Organization.  You should give copies to your primary care doctors and your family members, as well as the person you’ve chosen to receive power of attorney. Many people choose to keep a card in their wallet or wear a medical alert bracelet that would alert emergency medical professions to the exist of an advance directive.

No one wants to think about what might happen in case of terminal illness or a major accident. But the truth is, tragedies do happen, regardless of age or overall health. In these cases families often end up bearing both the emotional and legal or financial burden. One of the best ways to proactively help your family deal with this sort of tragedy is to make sure they know your wishes regarding medical care.