- The Washington Times - Wednesday, March 23, 2005

The legal dispute over whether to restore a feeding tube to Terri Schiavo is creating greater interest in living wills.

Living wills are instructions that people leave for their guardians if they become so disabled by disease or injury they are unable to make decisions for themselves.

Mrs. Schiavo does not have a living will.

“The amount of requests we have gotten in the past couple of weeks has skyrocketed,” said Jon Radulovic, spokesman for National Hospice and Palliative Care Organization (NHPCO).

The Alexandria nonprofit organization offers free state-specific forms allowing people to specify how they want to be treated when they become incapacitated. The group represents hospice care providers.

By noon yesterday, the organization received 540 requests for living wills by telephone and another 800 requests by e-mail.

“One lesson people can take away from this is that it really is important to talk about your wishes,” Mr. Radulovic said about the Schiavo case.

At Washington Hospital Center, which has one of the Washington area’s largest intensive care units, 5 percent of patients admitted to the hospital bring living wills with them, according to Janice Marie Vinicky, the hospital’s bioethicist.

About 15 percent of the population have them, but most neglect to bring them to the hospital, she said.

“I’m hoping that will change,” Miss Vinicky said.

About three or four times a month, the hospital’s staff looks for guidance from living wills on how to treat patients.

“We try to follow them as closely as we can,” she said.

Probate and elder care lawyers recommend at least two documents to adequately manage life-threatening situations.

The first is a living will for people to explain their wishes.

The second is a medical power-of-attorney document, which appoints a trusted person to make health care decisions for someone unable to make decisions alone.

Ron M. Landsman, an elder-law attorney in Rockville, said the medical power of attorney usually is the most important.

“There are just too many variables about what you’ll need to rest on a piece of paper,” he said.

In one case he handled, the son of an elderly woman who became incapacitated and a family friend argued over who should be the guardian.

“We had a knock-down, drag-out three-day hearing until the judge decided a granddaughter should be the guardian,” Mr. Landsman said. “Documents could have short-circuited that fight.”

Living wills vary slightly among jurisdictions in the Washington area.

The “advanced health care directive,” or living will, for the District of Columbia lists items that people can check or leave blank. They include:

• I do not want life-sustaining treatments, including CPR. If life-sustaining treatments are started, I want them stopped.

• I want life-sustaining treatments that my doctor thinks are best for me.

• I do not want artificial nutrition and hydration started if it would be the main treatment keeping me alive. If artificial nutrition and hydration is started, I want it stopped.

• I want artificial nutrition and hydration, even if it is the main treatment keeping me alive.

Suren Adams, a Bowie lawyer who prepares living wills for clients, advises entrusting the documents to someone who will act responsibly.

“Make sure you communicate those wishes to your family so it’s not something you put away and nobody knows it’s there,” Mrs. Adams said.

“You don’t need to put someone in a position to decide if they’re going to starve a family member,” she said. “I wouldn’t want to be the one making the decisions in that case.”

The end-of-life documents are available for free on the AARP Web site.

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