Take the case that many of us will remember -- that of Terri Schiavo. Terri's husband, Michael, fought a long and costly battle to have his wife, Terri -- diagnosed as being in a persistent vegetative state for several years -- disconnected from her life-sustaining feeding tube.

Michael in 1998 petitioned the Florida Courts to remove Terri's feeding tube, with ensuing involvement by politicians and advocacy groups of all sorts, including the Florida legislature, US Congress, and President Bush who returned from vacation to sign legislation to keep Terri Schiavo alive. All told, this was a 12 year long legal effort (1993-2005) and a major national news story.

To insure this zaniness doesn't happen to you, and that your wishes/instructions are carried out correctly, you need to have an updated living will and a durable power of attorney for healthcare (collectively, an "advance healthcare directive"). It doesn't take long to download a form, complete it, and have it readily available should, God forbid, the need occur.

Most of us almost never want to think about what could happen to our own medical care because of illness, an accident, or advanced age. However, if you don’t do at least some planning – writing out your wishes about the kinds of treatment you do or don’t want to receive and naming someone you trust to oversee your care – these important matters could wind up in the hands of estranged family members, doctors, or sometimes even the courts, who may not know what you prefer.

There are two basis documents that you set out your wishes for medical care (again, collectively known as an "advance healthcare directive"):

• A Living Will
  
• Durable Power of Attorney for Healthcare / Designation of Healthcare Surrogate

In addition to living wills, most states now permit you to name another individual to make healthcare decisions for you in the event that you are incapacitated or otherwise unable to make such decisions for yourself. A living will usually applies only to life-prolonging procedures. The durable power of attorney for healthcare is much broader than a living will and may apply to any medical situation, whether or not you are in a permanent vegetative state or terminal condition. A power of attorney for healthcare may also be referred to as a “designation of healthcare surrogate.”

The person you have designated as your attorney-in-fact or your surrogate may make decisions concerning your healthcare consistent with the authority you have granted. Most healthcare powers of attorney grant your surrogate the authority to make a great many healthcare decisions. Some of the more common decisions that are often covered in a healthcare power of attorney are as follows:

• To employ physicians
  
• To consent to or refuse particular treatments
  
• To decide whether you will be treated in a hospital, nursing home, hospice, or in your own home
  
• To make anatomical gifts
  

Copies of your advance healthcare directive should be given to your physicians and your family members or friends who may be involved with your medical treatment.

Q&A

(Q) If I spend considerable time in more than one state, should I execute living wills and powers of attorney for healthcare in each state?

(A) Many states have rules that honor out-of-state healthcare documents. However, it would be preferable to sign documents in the customary form of each state. It is more likely that physicians and others involved with your healthcare will honor your healthcare document if it is presented in a form familiar in that state.

(Q) May I specify an alternative healthcare surrogate to serve in the event that the primary healthcare surrogate is unavailable or unable to serve?

(A) You may designate one or more successor surrogates to serve in the event of the unavailability of your primary surrogate. It is sometimes preferable to sign two separate designations of healthcare surrogate, each naming a different surrogate, rather than naming both in a single document.

(Q) Who will make decisions for me if I don’t have a durable power of attorney for healthcare?

(A) Many states have enacted statutes permitting some medical decisions to be made by family members in order of kinship. Where there are no such statutes, many doctors and hospitals permit close family members to make important medical decisions. However, in the absence of a valid power of attorney for heath care, decisions may be made contrary to your wishes or by someone other than the person you wish to make such decisions. At the minimum, the absence of a power of attorney for healthcare will likely cause additional confusion and delay.

Below are sites to learn more and to download free forms you can complete for you and your loved ones.

Consumers Advanced Healthcare Directive  A free form from California's Attorney General's office with additional resources.

California Advanced Healthcare Directive - for Kaiser Insurance for those covered by Kaiser Insurance in California.

Aging with Dignity - 5 Wishes  A free, more comprehensive, advanced healthcare directive from the national non-profit organization, Aging with Dignity.

Five Wishes is a national advance directive that meets the legal requirements in 40 states and the District of Columbia (valid in California but not Nevada, Oregon or Utah in the West). The document combines two legal documents, a living will and health care power of attorney in addition to addressing matters of comfort care, spirituality, forgiveness, and final wishes. With help from the American Bar Association's Commission on Law and Aging and leading medical experts, a national version of Five Wishes was introduced in 1998. With assistance from the United Health Foundation, Five Wishes is now available in 23 languages and in Braille. More than 12 million documents have been distributed by a network of over 15,000 partner organizations worldwide.

• Wish 1: The Person I Want to Make Care Decisions for Me When I Can't
  

This section is an assignment of a health care agent (also called proxy, surrogate, representative or health care power of attorney). This person makes medical decisions on your behalf if you are unable to speak for yourself.

• Wish 2: The Kind of Medical Treatment I Want or Don't Want
  

This section is a living will--a definition of what life support treatment means to you, and when you would and would not want it.

• Wish 3: How Comfortable I Want to Be
  

This section addresses matters of comfort care--what type of pain management you would like, personal grooming and bathing instructions, and whether you would like to know about options for hospice care, among others.

• Wish 4: How I Want People to Treat Me
  

This section speaks to personal matters, such as whether you would like to be at home, whether you would like someone to pray at your bedside, among others.

• Wish 5: What I Want My Loved Ones to Know
  

This section deals with matters of forgiveness, how you wish to be remembered and final wishes regarding funeral or memorial plans.

I hope and pray that none of us have serious health problems, but when we do (or a loved one does) we get a healthy respect for life. Do yourself a favor and take an hour of your time and review the material and discuss it with your spouse, family, or friend(s) and determine what your wishes truly are -- you’ll be glad you did, and it will give you peace of mind.