Today I Learned: We Need To Talk

The Difficult Conversation Everyone Must Have

Did you know only 42 percent of Americans have a will or living trust? Did you know 100 percent of us will die?

If you want any say in who receives your property when you die, you need to make a will or trust. If you don’t care, that’s OK, too, because the state of California has prepared a will for you. It is called the laws of intestate succession and it determines which of your relatives will receive your property.

Don’t care for all your relatives? Want to leave something to charity? Then you need a will.

Fortunately, a will is easy. You can handwrite yours, and it’s legal in California. You can also go to the State Bar of California’s website and download a fill-in-the-blanks will. Or you can have an attorney write one for you.

We are all going to die and we ought to prepare. However, there is also the unthinkable — that we may someday become incapacitated. We may not be able to make all of our own decisions, either because we lack the cognitive ability or because we are too ill to do so.

You can sign a power of attorney for your financial affairs, but what about medical decisions? Who will speak for you when you can’t speak for yourself?

Did you know that, according to the Institute of Medicine, most people nearing the end of life are not able to make their own treatment decisions, including decisions about life support? It found “70 percent of older adults facing treatment decisions are incapable of making those decisions themselves.” 

So again, who will speak for you?

The landmark court case involving Terri Schiavo dealt with this very issue, beginning in 1998. Terri Schiavo was a young woman who suffered brain damage that left her in a persistent vegetative state and was kept alive through tube feedings.

The U.S. Supreme Court had previously determined that patients have an absolute right to refuse medical treatment, even life-sustaining treatment, but Terri could not make her wishes known. So the question was, “Who speaks for the patient?”

Terri’s husband wished to remove the feeding tube, according to what she would have wanted, but her parents objected. The case dragged on until 2005, with multiple government officials, including President George W. Bush weighing in, before she was finally allowed to die.

Did you know you can avoid such a scenario by simply filling out an advance directive? This document combines a durable power of attorney for health care and a living will. It allows you to name someone who will speak for you and also to designate what treatment you want at the end of life.

You can download the document from the Internet, fill it out and give copies to your designated agent and members of your health care team. Then there will not be a question of who speaks for you.

I was my father’s agent for medical decisions. When he was in failing health and hospitalized, a physician called me for permission to perform a bronchoscopy. I checked Dad’s advance directive and read that he did not want his life prolonged if he had a terminal condition or was permanently unconscious.

I couldn’t find “bronchoscopy” anywhere. Nevertheless, I believed he would want to refuse, and so I did. Then after Dad died, I sat down with my sister, who was my agent for health care, and told her exactly what I wanted done if she had to make the decisions.

So my final word is: Don’t put your loved ones in the position of having to guess what you would want. Have the difficult conversation. You and they will be glad you did.

 Originally published in the Ventura County Star, October 21, 2017