Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: MONDAY, March 13, 1995 TAG: 9503140023
SECTION: MONEY PAGE: 6 EDITION: METRO
SOURCE: MAG POFF STAFF WRITER
DATELINE: LENGTH: Medium
THE recent deaths of Richard Nixon and Jacqueline Kennedy Onassis, plus the debate over health-care reform, have revived interest in living wills or, in Virginia's legal parlance, advance medical directives.
A living will is an individual's written declaration of what life-sustaining medical treatments he or she will allow - or not allow - in the event of incapacitation. For example, the person may request that artificial nourishment be withheld if he or she is terminally ill.
The Institute of Certified Financial Planners said that nearly all adults should have a living will.
Both Nixon and Onassis had signed living wills. Onassis, terminally ill with cancer, returned to her home from the hospital in her last days according to her instructions. Nixon had signed his document before he suffered a massive stroke.
The financial planners said the debate over health-care reform also has sparked renewed interest in living wills because of the high cost of dying. About 30 percent of the total U.S. health care bill each year is racked up in the last six months of patients' lives.
Often treatment is given even though the patient's family and doctor know the life-sustaining efforts are futile. The family is reluctant to "pull the plug" and the doctors are reluctant for fear of being sued.
In Virginia, the best legal document is known as an "advance medical directive."
Neil V. Birkhoff, an estate specialist with the Roanoke law firm of Woods, Rogers & Hazlegrove, said the law providing for such instructions went into effect in 1992 in the Health Care Decisions Act.
An advance medical directive authorizes the type of medical treatment permitted in case the signer becomes incapable of making medical decisions.
Birkhoff said the General Assembly enacted the law after a significant lobbying effort by hospitals and physicians who wanted more explicit directions from their patients.
The code sets out the provisions for the document and most lawyers follow it, Birkhoff said, but an an individual can add his or her own provisions.
Birkhoff said the usual directive has two parts:
The first is the traditional living will in which the person covers the types of treatments that are acceptable or unacceptable and the circumstances in which these options come into play.
The second part is like a medical power of attorney. Birkhoff said it designates the person whom the signer wishes to make medical decisions on his or her behalf if the signer can no longer make informed medical decisions. No other powers, such as the ability to make business or financial decisions, are bestowed on the designee.
The directive is notarized when it is signed.
Birkhoff said he gets few calls from people who want an advance medical directive written, but he writes many of them. That's because he recommends them to every person who comes to him for a will. The will and the directive then are signed at the same time.
Virginia is on the cutting edge of a national movement toward adoption of the concept of advance medical directives, Birkhoff said. He said the Virginia General Assembly enacted the law shortly after some of the larger states set the example.
Anyone who signed a living will prior to 1992 should check his or her documents, Birkhoff advised. Anyone who has a separate living will and medical power of attorney should have no problem, he said, but many people signed living wills without the related paper.
People who lack a medical power of attorney probably should prepare and sign an advance medical directive empowering someone to make medical decisions, Birkhoff said. That's because not every medical situation can be foreseen when the living will is prepared.
The Institute of Certified Financial Planners said preparing an advance medical directive can provide comfort to the individual and direction for the family members.
It also can minimize medical expenses paid for by the family or taxpayers. Recently, the planners said, a man refused to pay a nursing home for treatment his wife received after he requested, according to her wishes, that she be taken off her feeding tube. But a court ruled he had to pay because there was no written document expressing her wishes.
Anyone who wants to sign an advance medical directive can copy the language of the example set forth in Volume 8 of the Virginia Code, which can be found in public libraries. The language for a directive, with several options, is in Section 54.1-2984.
by CNB