Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: MONDAY, July 2, 1990 TAG: 9007020036
SECTION: NATIONAL/INTERNATIONAL PAGE: A1 EDITION: METRO
SOURCE: Associated Press
DATELINE: WASHINGTON LENGTH: Medium
"We've had to get volunteers to help us man the phone lines," said Doron Weber, a spokesman for the Society for the Right to Die. "That's the magic word right now - living wills."
Living wills allow people to spell out in writing how much medical care - if any - they would like to have in the event they ever become critically or terminally ill and are unable to speak for themselves.
The urgency of such advance planning was brought home last week when the Supreme Court barred the parents of a 32-year-old comatose woman, Nancy Cruzan, from ordering removal of the feeding tube that is keeping her alive.
Doctors say the Missouri woman is irreversibly unconscious, in a permanent vegetative state that could last for years. Her parents wanted to have her feeding tube removed, but the court said no.
The court said states may block family members from ending the lives of permanently comatose relatives who have not made their wishes known. The justices indirectly supported living wills by saying the Constitution guarantees a competent person a right to refuse medical treatment.
The American Medical Association estimates that 70 percent of all people will be involved in some way at some time in a decision on whether to prolong or terminate life support.
The Society for the Right to Die has become a sort of national clearinghouse for living wills.
"We're getting thousands of calls every day, the vast majority from individuals who want living wills," Weber said in an interview last week.
Interest in the issue was lively even before the ruling in the Cruzan case. Before last week's decision, the American Association of Retired Persons had received more than 100,000 requests for its booklet "Health Care Powers of Attorney," produced by the American Bar Association.
The Society for the Right to Die distributes the appropriate forms for the 41 states and the District of Columbia that have living-will laws.
For people in the nine states that don't have a law, the society has general forms. Those states are Massachusetts, Michigan, Nebraska, New Jersey, New York, Ohio, Pennsylvania, Rhode Island and South Dakota.
For people in all states, however, the society advises that individuals be as specific as possible.
"It's a very important document," Weber said. "You should say everything you want to say, whatever your personal instructions are. . . . You have to make your wishes known."
The American Bar Association approves of living wills, but recommends that people also give someone they trust what is called durable health care power of attorney.
This is done in a written document and gives the person named the authority to make health care decisions for an individual in the event that individual becomes unable to speak for himself or herself.
This allows people to cover more contingencies than may be possible to outline in a living will, and to provide more guidance for decision-making.
"Medical technology changes by the year, if not by the minute," said Nancy Coleman, director of the ABA's Commission on the Legal Problems of the Elderly.
A living will provides a certain measure of protection for your wishes to be carried out, she said, but it doesn't give anyone any alternative decision-making for you.
"If you forgot something or something new [life-prolonging medical technology] is available that you didn't anticipate . . . you could be in Nancy Cruzan's situation," she said.
While all states and the District of Columbia recognize durable power of attorney, some states also recognize this power specifically for health care decisions.
But the interpretation of most attorneys who practice in these areas is that you can use durable power of attorney for most health care decision-making, she said.
Whether in a living will or in designating power of attorney, Coleman advises people to "say whatever they want to say as strongly as possible."
When drafted, these documents should be given to family members, friends, physicians, religious advisers and "anyone else you would want to speak on your behalf," Weber said.
"You don't want to stash it away in a safe deposit box," he said.
Forms can be obtained from the Society for the Right to Die and Concern for Dying by writing to them at 250 West 57th Street, New York, N.Y. 10107.
The American Association for Retired Persons' booklet "Health Care Powers of Attorney" can be obtained by writing to AARP Fulfillment, Stock No. D13895, 1909 K Street, N.W., Washington, D.C. 20049.
by CNB