Advance directives: Talk now about plans for later care

In the wake of the Terri Schiavo case, more people are contemplating these instructions. That makes now the perfect time to discuss them with your patients.

Editorial. Dec. 15, 2003.

The prolonged and highly public feud between the husband and parents of Terri Schiavo over whether to remove her feeding tube has doctors and their patients all across the country giving more than a passing thought to advance directives for care.

Such a directive is often cited as the best way to avoid the uncertainty at the center of Schiavo's case -- whether she would have chosen death over living in a "persistent vegetative state." There is no written statement of her feelings on this most difficult of choices, and those who know her best disagree vehemently about what she would have wanted.

The toll this battle has taken on all who have been involved in it has not been lost on health care professionals or the general public. In an instant poll taken between Oct. 31 and Nov. 8 on the Medscape Web site, 80% of nearly 1,250 health care professionals -- and 72% of the ones who identified themselves as physicians -- said they were now more likely to recommend an advance directive/living will. And the Tallahassee, Fla.-based organization Aging with Dignity notes that orders for its "Five Wishes" document, which meets the legal requirements for advance directives in 35 states, have increased 10-fold, to 5,000, since mid-October.