Advance Medical Directive made easy Published Dec. 1, 2011 By Capt. Brian Peterson 87th Air Base Wing Legal Office JOINT BASE MCGUIRE-DIX-LAKEHURST, N.J. -- Many people may be aware of the story - though we may be forgetting the lessons - of Terri Schiavo, the brain damaged woman whose family argument was broadcasted across the nation and the world. Over the years following the public dispute, these events have brought a large number of people to the legal office looking for information on how they can prevent themselves from being the next "Terri Schiavo." The Joint Base McGuire-Dix-Lakehurst Legal Office provides two documents which collectively make up the Advance Medical Directive. The first is the living will. This is the document whereby an individual states, "In the event I am being kept alive by artificial means and have little chance to recover, I wish to have life sustaining procedures withheld." It is a fairly simple document, and can be tailored to fit anybody's wishes and desires. The second document is commonly known as the Power of Attorney for Health Care, or a "Health Care Proxy." This document gives a specified individual the ability to make health care decisions for the person being treated, should he or she become incapacitated. This means in the event he or she is in an accident and cannot speak, the doctors can discuss what course of action to take with the designated agent. It also gives the agent the power to make the decision to terminate life support systems, if it is the patient's known wish. One question people get confused about as they are filling out their living will is defining a terminal illness. There are situations where individuals will be incapacitated and on life support and have medical procedures which could prolong life, but only for a finite period of time. This is different from the first part of the living will, whereby it is assuming he or she will live on for an indefinite amount of time with the use of life support machinery. By defining that finite time, he or she can empower the designated agent to refuse the procedures and terminate the life sustaining treatments. For example: A man is on life support and in a coma. The doctor comes back to his family and says that with everything they can do procedurally and with the life support equipment, he will only live for another year. If he chose in his living will to define terminal condition as five months, his designated agent cannot deny a procedure or terminate the life sustaining treatments for the first seven months of that year. They must wait until the doctors determine he only has five months left to live before they can act on his behalf. The time a person wishes to define as a terminal illness is completely up to them and is different for everyone. If he or she wants to hold out until the last possible moment, that is within his or her right. The members of the JB MDL Legal Office don't advocate one position or the other. Another important decision is selecting the health care agent. People often choose a spouse or parent. There is no problem with this, but as long as the agent understands the patient's wishes and will carry them out. There was a case in the nearby Delaware Valley going on at the same time Schiavo's feeding tube was being removed. A man suffering from Alzheimer's specified in a living will that if a feeding tube was needed to keep him alive, he didn't want such treatment. His wife, the designated health care agent, ordered doctors to insert a feeding tube, ignoring her husband's wishes. The couple's daughter took her to court to prevent the insertion of the feeding tube. If a person knows his or her spouse will not be able to carry out his or her wishes to deny medical attention that merely prolongs life, then he or she should not choose the spouse as an agent. They should choose the individual that will follow the desired wishes. This leads to another important point of living wills - communication. A person should inform the family of the wishes and of the existence of a living will. Some speculate if it was indeed Terry Schiavo's wish not to be kept on life support, she should have told her parents as well as her husband. This might have prevented a lot of the heartache. While signing a formal document is good, talking to family and friends about desired wishes takes it one step further. The current culture has an aversion to talking about such topics as death and serious illness. The old adage, an ounce of prevention is worth a pound of cure, certainly rings true with regard to living wills. It is best to get a living will done under the laws of the state of current occupancy, because every state has different laws and there is no national standard. It is an ideal idea to get a living will updated with every permanent change of station. Updating the document every four years is also recommended because a person's attitude can change over time. Always discuss changes with family and the designated agent. All servicemembers should have an advance medical directive - along with a will drafted and executed. One of the main objectives of the JB MDL legal office is to make sure all Airmen, Soldiers, Sailors and Marines are well settled when it comes time for them to perform the mission here and abroad. It is important to be prepared for all circumstances and events. Call the legal office at 754-2010 with any questions, or to schedule an appointment for directive. Appointments are available on Mondays, Thursdays and Fridays. Walk-in service is available from 9 to 11 a.m. on Tuesdays.