People can take two crucial steps to protect their interests: Designate someone they trust to be their "health care proxy" to make decisions for them if they are unable, and make sure their wishes are clear, often through a document known as a "living will" or an "advanced medical directive."
Both documents can be drawn up by a lawyer, but many people can simply fill out forms that are widely available on the Internet or through one of the many nonprofit groups promoting such measures. Because state laws vary, it is important to pick the form that applies to the state where you live. In Maryland, Virginia and the District, residents can use fill-in-the-blanks forms, without a lawyer's guidance. The forms typically allow you to check off what type of medical care you wish to receive.
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The Battle for Schiavo|
A look at the long legal battle over whether Floridian Terri Schiavo, 41, may be taken off life support.
Feb. 1990: Schiavo suffers brain damage from heart failure.
Feb. 2000: Circuit Judge George W. Greer rules that Schiavos feeding tube may be removed, as requested by
April 2001: The feeding tube is removed. Two days later, Circuit Judge Frank Quesada orders doctors to
June 2003: The 2nd District Court of Appeal upholds Greers ruling to remove the tube.
Oct.: Gov. Jeb Bush files a federal court brief urging that Schiavo be kept alive.
He is denied.
Doctors remove the feeding tube.
The state legislature passes a bill, called "Terris Law," allowing Bush to intervene. He orders the feeding tube
Sept. 2004: Floridas Supreme Court rules that Terris Law is unconstitutional.
Jan. 2005: The U.S. Supreme Court declines to hear the governors appeal.
Feb.: Greer grants an emergency stay blocking the removal of Schiavos feeding tube. He later sets March 18
as the day the tube may be removed.
Mar. 16: House passes legislation to try to block efforts to let Schiavo die.
Mar. 17: Senate passes separate legislation.
Mar. 18: House committee subpoenas Schiavo and others. Florida judge blocks the subpoenas; U.S. Supreme
Court lets that ruling stand. Feeding tube is removed.
Mar. 20: Senate passes legislation giving federal courts jurisdiction in the case.
Mar. 21: House passes the same bill, sending it to President Bush for his signature.
SOURCES: Associated Press, staff reports
"Most people think of these documents as opportunities to say, 'I don't want to be kept alive,' but they are also your opportunity to say, 'Hey, I do want every medical step,' " said Kathy Brandt, vice president for the National Hospice and Palliative Care Organization.
Francis E. Yeatman, a Bethesda lawyer, said the forms generally work fine. But some lawyers, including Thompson, said it is better to draw up a customized living will that gives doctors and family more specific guidance and would hold up better under court challenge.
Several commercial organizations have sprung up allowing people to file their documents online so that they are easily available to hospitals and doctors in an emergency.
Experts said that because it is impossible to anticipate every possible scenario, the most reliable strategy is to designate someone who can be trusted as your proxy.
But several said it is also important that as many friends and family members as possible understand their loved one's wishes.
"If your surrogate is the only one you talk to, there may be a dispute because, for example, the other siblings may say, 'Mom never said that to me,' " said Barbara Coombs Lee of Compassion and Choices, an Oregon-based group. "So you really need to speak openly with everyone."
Coombs Lee and several others noted, however, that even with such documents, many cases still end up in court when family members disagree. And doctors are often hesitant to follow directives, particularly if they are unclear.
"It's not perfect by any means," Coombs Lee said. "But it's all we have."
Staff writer Neely Tucker contributed to this report.