A Matter of Life and Death

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Bonnie Simmons doesn't want things to end for her the way they have for Terri Schiavo—the Florida woman being kept alive artificially as her husband and parents battle each other in court to decide her future.

Simmons, 72, of Celebration, Fla., plans to talk to her family and doctors and put into writing medical treatments she wants and doesn't want when death seems near. "I don't want my family to go through what the Schiavo family has gone through," she says.

Simmons isn't alone. Since the Schiavo case made national headlines this fall, end-of-life experts and attorneys are fielding an unprecedented number of calls.

Paul Malley, president of Aging with Dignity, a nonprofit group that assists families with end-of-life issues, says he's seen a tenfold increase in calls since mid-October.

People are acting to avoid the type of situation that has torn apart the family of Terri Schiavo, the 39-year-old woman who has lived 13 years in what doctors describe as a persistent vegetative state. Her husband wants her feeding tube removed, but her parents want to continue life support.

The legal battle led the Florida Legislature in late October to pass controversial legislation letting Gov. Jeb Bush (R) postpone the Florida Supreme Court's August action that allowed removal of Schiavo's feeding tube. The case continues in the courts. [See Faceoff: Should Lawmakers Overrule Courts in Life-Support Cases?]

So far, about 25 percent of American adults have a living will, which specifies the medical treatment people do or do not want if they become terminally ill or incapacitated. All states recognize living wills and a second type of advance directive, the durable medical power of attorney.

A durable medical power of attorney, also called a health care power of attorney, is a document in which an individual appoints someone to make decisions about health care if he or she is unable to do so.

For her part, Florida's Simmons is using "Five Wishes," a document developed by Aging with Dignity. Five Wishes, recognized by Florida and 34 other states, combines the two types of advance directives and helps engage individuals to think and talk about their wishes.

To ensure that dying wishes are honored, experts urge all adults to complete both a living will and a health care power of attorney.

"The paper should be the memorialization of the conversation you've had with your family," says Sally Hurme, an AARP consumer protection attorney.

"An advance directive is not just to terminate care but to express your preference for the care you wish to receive," Hurme adds.

Meanwhile, Simmons says she will tell her doctors and family "just don't jump the gun" if she becomes incapacitated. While Simmons will make clear that she wants all attempts to recover taken, she does not want any heroic steps to continue her life if doctors decide she has no chance of recovery.

Christopher J. Gearon is a freelance writer in Washington, D.C.