And just to clarify my previous comment: As I said, HR 3200 (the current House bill on health care reform) ALLOWS a person to talk to a doctor. It does NOT REQUIRE anyone to talk to a doctor EVER! It does NOT REQUIRE ANY medical practitioner to initiate a conversation on the subject. It merely ALLOWS a patient to ask for an appointment to talk to their doctor on the subject, AND FOR THE DOCTOR TO GET PAID FOR THAT APPOINTMENT, unlike the current situation. If he or she is going to spend valuable time, they out to be able to bill for it.

It is ridiculous that I have to clarify in this manner, but Sarah Palin and Betsy MaCaughey and their ilk have so demonized (literally!) this subject that it is necessary. What a said commentary on 21st century America!

Pr Chris

I'd guess that the basic answer to this columnist is that the conditions that were supposed to trigger her living will were not read carefully, and perhaps the living will was not drafted carefully enough. But waiting until the time comes is really stupid counsel. Surely as a doctor she has seen people come in with sudden trauma that makes it impossible to state their wishes. And just how are they to make their decisions known at that time?

The provisions that are in HR 3200 (and I hope the House DEMANDS that they be put back in during conference!) allows one to meet every five years with a doctor. If this is done, the living will one drafts may very well change significantly, that's true. It will reflect new options in care that have come into practice; it will reflect five more years of life experience on the part of both patient and doctor and changed physical and perhaps mental conditions. But that's fine. In fact, that's ideal. Not just to write one at age 21 and have it be defined for the rest of one's life, but to PERIODICALLY stop and take an assessment of what one wants and why. The bill could have said every seven years, or every 10 or every other year, but it seems to me that every five years, or whenever there's a major medical/ life change is a good default position.

Nothing this columnist wrote convinces me that a well drafted living will, written periodically is not a really good idea. Should we wait for the wills that define our estates and the care of minor children to wait until the last minute, too? I've seen what happens on that one. Good Luck.

I'd encourage everyone to have a living will immediately. Spend a week or so thinking about various possibilities and how you would want to respond to them. If you have a brain injury, for instance, what capabilities make life worth living? Mere consciousness? The ability to read a book or follow a TV show plot [assuming there IS a plot]? use these sorts of questions to not only state: I do not want to be kept alive after a stroke (no one questioned the patient in the example, for instance as the ramifications of her positions?), but: I do not want to be kept alive after my condition has stabilized after a stroke if I cannot do X, Y, or Z. If I am to be deaf and blind, for example (becoming Helen Keller at age 70 is more of a challenge than I want to have!). And then write out a living will. Do it this year! No matter HOW old you are. Talk it over with your family or close friends. Let them challenge you; it will be a better outcome!

Pr Chris

It's looking like I'll be leaving a big mess behind. Even my birthday was a mess.

There is so much wrong with your comments that it almost defys logic to answer but to me the most ridiculous of all your comments is when you say she didn't talk because everyone else was talking. And as far as letting a family member or one with a close personal relationship make the choice pre-suposes that that person has no personal gain from the death of the patient. And maybe the patient has no religous affiliation.
No. I'll make my own decisions. And if everyone else is talking I'll just be rude enough to interupt them. Wouldn't you?

Anne and Albert,

For you to say "Spending money for doctors to counsel patients on Living Wills before that last moment is a waste of money and time that could be better spent otherwise," as if that is what the bill requires or even intends, is at best disingenuous and at worst deliberately misleading and inciteful; especially inciteful for the crazy, malicious fringe that threatens violence.

This level of irresponsibility is inexcusable for people of intelligence and standing, even for those who allow ideology to trump the truth for political gain.

This whole paranoia about living wills and other inflated concerns is part of trying to raise hysteria about health care reform, and ...I'm not seeing it as worthless. In fact, it could save a lot of grief and legal expense and family strife and the like.

This is insufficient anecdote to claim it's a waste:

"I happened to walk by and she called out to me. I went to see her, surprised that she could call out to me. Not only that, but I discovered that all her mental faculties were intact. She told me "I'm not ready to die just yet." So her true desires as she faced death were not those written in her Living Will."

Well, the last I heard about living wills is that they were prepared against the event when you're *not* able to decide for yourself.

This is *not* the 'Bring Out Your Dead sketch from Monty Python. *Obviously* putting in place a will regarding your own incapacity to speak or think doesn't mean you lose the right to say 'I want to go through this.'

"Patients should make desires known to families and perhaps to a minister, priest, rabbi or religious person with whom they may have a close personal relationship. Then should a patient be comatose or demented, those closest to the patient will know what is desired."

You assume such people are friendly to the patient or her desires.

How do you tell, have em write a living will?

Not a bad stipulation to *make,* actually, but most of the clergy I trust aren't exactly flush enough to take it to a court battle if there's big money to be made off a life support rental.

*Obviously* if you can