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HMS Guide Urges Patients To Specify Medical Wishes

By Peter Zuckerman, Contributing Writer

Harvard Health Publications recently released A Guide to Living Wills and Health Care Proxies, which aims to provide adults with a means of expressing their wishes for medical treatment in case they are rendered incapable of voicing them.

“Most people value their ability and freedom to make choices,” the guide reads. “But what if you’re unable to make your decisions or wishes known? Say for example you are temporarily unconscious and can’t speak or hear.”

The guide gives advice on how to approach these medical decisions in advance and includes some of the documents families would need to prepare.

“Our goal with this report is to explain what people need to know, and to give them the tools by which they can create a health care proxy or living will in just a few hours, on their own,” Dr. Anthony Komaroff, editor-in-chief of Harvard’s Medical School Publications, told the Harvard Gazette.

The guide, which costs $20, is intended to increase the awareness and use of advanced care directives, documents that few people currently draw up, according to Ed Coburn, the publishing director of Harvard Health Services.

“It’s a painful topic for people, so they put it off until it’s too late,” Coburn said.

Coburn said while the process might be difficult, living wills and health care proxies can reduce the grief shared by relatives of debilitated adults.

He said the case of Terri Schiavo, who is currently on a feeding tube and the subject of a family feud, illustrates the need for health care directives.

Schiavo did not provide any written directives about the steps that should be taken if she lost consciousness, and her spouse and parents are now fighting over whether she should be kept alive.

After a series of court decisions gave Schiavo’s husband the right to remove the tube that has sustained his wife since 1990, the Florida Legislature ruled last Tuesday in favor of her parents. And Schiavo has been put back on the tube.

But with a living will, an adult can precisely outline what they want to be done if they lose the ability to express their wishes. A health care proxy assigns control over the adult to a particular individual.

Currently, state laws recognize the spouse as the surrogate of a married individual who does not sign a health care proxy.

Although it is possible for an adult to draw up only one of the two health care directives, the Harvard Health Publications guide recommends that both be filled out.

Coburn pointed out that, in contrast to a traditional will, neither document is difficult to create.

In addition to providing information on the directives and many of the necessary forms, the guide gives advice on talking to loved ones about drawing up the documents.

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