November 24, 2008 · Updated 4:53 PM
By Vicki Rackner, M.D.
Terri Schiavo and her family have given us a gift. They remind us that planning for your death is your final act of love.
For the past few weeks, we have witnessed painful lessons we would prefer to ignore. Death is a part of life. Tragic medical events befall even young people, often at unexpected times. And difficult decisions accompany the final days of life.
When you enter the medical system, your job as a patient is to make choices. The process, called informed consent, involves weighing the risks and benefits of one intervention and comparing it with alternatives. While these are called medical choices, they are really personal choices, reflecting your values, preferences and spiritual beliefs. That's why, according to laws, medical ethics and common decency, you as the patient are the one who chooses.
You always have the option of choosing no treatment at all. Our law states that a competent adult has the right to refuse treatment even if it means that he or she will die without it.
One day you may not be in a position to make choices for yourself. The medical and legal systems have provided mechanisms to guide the decisions you would make for yourself -- if you could.
This is a good time to complete and sign two important legal documents: your ``advanced directive,'' sometimes called a ``living will,'' and a durable power-of-attorney. The advanced directive outlines your wishes for medical treatment. Give your doctor a copy and take it with you should you enter the hospital. Let your family know where this document is. You can also assign a durable power-of-attorney form that identifies the person who will make the choices for you, if you become unable to make them yourself.
The papers summarize important conversations you need to have with your doctor and with those you love. Give those who will make choices as clear a roadmap as possible.
You may be asked to make choices for others you love, like your parents. This is a good time to approach them with this delicate conversation. Say, ``Mom and Dad, I'm so happy that you're in good health. It's painful to even consider your final days. I love you and want to make sure your wishes are honored, even if you can't state them yourself. If you cannot speak for yourself, who would you like to speak for you? What would you want if you were in Terri Schiavo's condition?''
If you find yourself in a position of making choices for someone you love, remember this. Your job is not to make the choice you think is best. Your job is to make the choice you think your loved one would make for himself or herself.
You can honor Terri Schiavo's life and legacy by planning for your own death. Hopefully you will die in peace and comfort, surrounded by those you love. By communicating your end-of-life wishes in advance, you offer a gift to those you leave behind. And in deciding how to die, may you get a renewed vision of how you want to live.
Vicki Rackner, M.D., is president of Medical Bridges. She can be reached at DrRackner@medicalbridges.com or 425-451-3777.