written by Kenney Hegland

If you’re me, you have a Living Will. If you’re me, you have no idea where you put it. If you’re me, you have only the vaguest recollection of what it says.

We start with the proposition that we all have the right to reject any and all medical interventions even if it means our death. But what if, at the time the decision must be made, we are either legally incompetent or unconscious and hence unable to make any decision? They’ll keep us alive, pretty much no matter our condition or hopes of recovery.

Living Wills were a great achievement in the law. Too many people die horrible deaths in Intensive Care, in pain, receiving futile and expensive treatment. A Living Will allows you to dictate “no tubes, no heroic measures.” Studies show, however, that they are not that effective: docs do pretty much what the family wishes. Loved ones have a better sense of things now, than you did then.

While you should have a Living Will (they can often be the tie-breaker in case of family dispute , so it would be worth finding yours), far more important is a Health Care Power of Attorney. You choose an agent to make medical decisions if you can’t (at any time, not just when you are terminally ill as in the case of Living Wills ). Your agent can make sure your wishes are followed; agents can go the hospital and shout.

Before you scurry off to search the web for a form, know this. The more bells and whistles a document has, the more effective it will be. Have yours prepared by a lawyer. If there is a dispute over the kind of treatment you will receive, doctors will take far more notice of a document with a lawyer’s name on it – docs usually pay attention to lawyers even though, for some unknown reason, they don’t generally us.

Who you want as your agent? Often people appoint their spouse but, if the time comes, your spouse may not be capable of making hard choices and may even have a hard time shouting.

The key to this whole thing is a serious talk with your agent (and the backup) about your wishes. This may be part of a broader family conversation about end-of-life matters. Some things to consider:

Tell your agent to insist on a prognosis. Docs are often reluctant to give bad news. They are trained not to give up; no where in medical texts is the advice,”If that doesn’t work, give up.” And doctors fear making a self-fulfilling prophecy. (In Wilde’s Importance of Being Earnest, one character, reporting on the death of another, explains that his doctor had given him only a short time to live. Another responds, “He seems to have had great confidence in the opinion of his physician.”)

A good question to ask the docs: “Would it surprise you if your patient died in the next few weeks?”

Discuss what treatments you don’t want. This is the stuff of traditional Living Wills . By the way, one author, having revi...