Schiavo case creates push for living wills

Monday, March 21, 2005

TAMPA, Fla. -- Terri Schiavo didn't have a living will. But because of her, thousands of other Americans won't make that same mistake.

Lawyers and organizations that promote the importance of living wills and advance directives say the bitter legal battle over the severely brain-damaged woman has led many people to put their end-of-life wishes in writing.

At lawyer Christopher Likens' office in Sarasota, clients invariably bring up Terri Schiavo as they put their affairs in order.

"Almost universally, it's 'That poor girl. I don't ever want that to happen to me,"' Likens said. "People are much more informed about the issue."

Most American adults -- estimates are as high as 75 percent -- do not have written directives for their families to follow.

Schiavo did not, and her fate has been debated in court for years as she lies in her hospice bed. Her feeding tube was removed Friday, but Congress worked through the weekend on a compromise to reinsert it, as has been done twice before. No decision had been reached on Sunday.

"I think everyone can agree this is not the way the decision should be made," said Paul Malley, president of Aging with Dignity, a Tallahassee-based agency that created the living will known as "Five Wishes."

Orders for the will have been pouring in as the Schiavo case again grabs headlines worldwide. The group is sending out more than 2,000 living wills a day, with many people requesting multiple copies to distribute to family members.

200 an hour

Aging with Dignity estimates requests for its advanced directives are up tenfold because of the Schiavo case. In October 2003, when the case became an international sensation, on some days orders for living wills were pouring in at a rate of 200 an hour. The group has distributed 1 million copies of its living will since then.

"We get requests saying, 'We have seen what happened in the Schiavo case and above all, we don't want to see that same tragedy repeat itself in our family,"' Malley said.

Terri Schiavo was just 26 when her heart stopped because of a chemical imbalance believed to have been brought on by an eating disorder, leaving her severely brain damaged for the past 15 years.

Her husband, Michael, and two of his family members have testified she told them she would never want to be kept alive artificially after she saw a TV program involving an end-of-life story and witnessed a relative endure a difficult death.

But her parents, Bob and Mary Schindler, dispute their daughter had such wishes, and the result has been a bitter court battle that has waged for more than seven years.

Doctors have said Terri Schiavo is in a persistent vegetative state, but her parents insist she can be rehabilitated with treatment.

After a judge ruled that her feeding tube could be removed, Michael Schiavo had a warning for other families, telling viewers of ABC's "Nightline": "Make a living will, talk about it. Death is going to happen. You need to write it down."

Living wills are documents that communicate patients' wishes on medical treatments should they become terminally ill or incapacitated. An advance directive is a living will that includes the designation of a medical surrogate to carry out the expressed wishes.

4 million documents

In the six years since Aging with Dignity created its Five Wishes will, the group has distributed a total of 4 million of the documents. Malley said the group has also been working with more than 600 employers nationwide, ranging from federal agencies to industrial conglomerate 3M to small restaurants, to hand out the directives.

The documents don't mean there will never be a court fight over a person's fate. They require that someone is terminally ill, completely incapacitated with no hope for recovery or in a persistent vegetative state. Those are all conditions subject to medical debate and disagreement among family members.

"People are certainly more protected if they had it in writing, but I am not convinced that if Terri had a living will in writing -- given the dynamics of this situation -- there still may be some issues out there," Likens said.

"I think her family truly believes she could be rehabilitated. Even if they had a written directive ... they might still be arguing."

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