Take My Spouse, Please

Not So Fast Don't assume your spouse wants you to make medical decisions he or she can't make. When asked to select a health care proxy -- someone designated to make medical decisions for a person who is incapacitated -- one-third of married respondents chose someone other than their spouse, according to a study published on the Journal of General Internal Medicine's Web site.

The Deciding Factors "We discovered that many, many times, the choice of who someone wanted as a decision-maker was unexpected," said study author K. Michael Lipkin, assistant professor of clinical preventive medicine at Northwestern University's Feinberg School of Medicine.

Some study participants said they didn't want to burden their spouse; others reported being worried that differing beliefs might pose a problem in ensuring that their wishes were honored. Some cited cultural reasons for preferring, for example, that their father, rather than their spouse, make such medical decisions.

Lipkin notes that the study was "not necessarily representative of the general medical population." Participants included 298 people -- ages 19 to 96 -- who arrived for routine care at a Chicago eye clinic; 45 percent were married. About 38 percent of participants were white, 57 percent were black, 7 percent were Hispanic and 9 percent were of another race or ethnicity.

Choose Now The study highlights the need to designate a health care proxy long before becoming sick, elderly or disabled, Lipkin said. When selecting a proxy, "choose someone who knows you well and whom you trust and who is willing to take this role," he advised. Write your wishes down and "make it known to the entire family and everybody else that's involved and to your doctor."

In writing down wishes, Lipkin cautioned against over-specificity: "People will put down 'I don't want to be on a ventilator' when there are many times when being put on the ventilator tides you over [through] a crisis and you can recover," he said. "And if you've said 'no ventilator,' you've really locked the door. . . . A written document can't change its mind."

-- January W. Payne