Why Have a Living Will or Health Care Proxy?

Living Will or Health Care Proxy: The Terri Schiavo Case

The Terri Schiavo case is a landmark case that was on everyone’s minds. The bitter battle between her family and her husband lasted a decade and a half after Terri suddenly collapsed in 1990. However, her story has had an enormous impact on the American consciousness, demonstrating the importance of having a living will and health care proxy.

The Schiavo Case

On February 25, 1990, Terri Schiavo collapsed at her home in Pinellas Park, Florida, and suffered severe brain damage when her heart stopped beating for several minutes. While Terri was able to breathe and maintain a heartbeat on her own, she never regained any higher brain function and was determined to be in an irreversible persistent vegetative state. In 1998, Michael Schiavo, Terri’s husband, petitioned the court to have her feeding tubes removed, saying that his wife would not want to be kept alive artificially if there was no chance of her recovery. While Terri’s parents, Bob and Mary Schindler, objected to Mr. Schiavo’s petition, Judge George W. Greer ruled in favor of Mr. Schiavo’s request to remove Terri’s feeding tubes. However, for the next 12 years, Terri’s parents and her husband would argue over what Terri would want. In March of 2005, Terri’s feeding tubes were again removed and on March 31st, after two weeks without food and water, Terri died of dehydration.

With no living will or health care proxy, Terri’s parents and husband were forced into a legal battle as to how to interpret Terri’s own wishes. Would she have wanted to die with dignity or remain in an irreversible persistent vegetative state while her husband argued with her parents? Or would she have wanted to keep fighting with the hope that she might be able to recover? Without a living will or health care proxy, the one question that will always plague Mr. Schiavo and Terri’s parents is whether either of them knew what Terri really would have wanted to happen.

What is a Living Will?

A living will is a legal document that is essential in spelling out your end-of-life decisions. It provides you with an opportunity to specify whether you would want certain medical treatments to be used to prolong your life where the likelihood of your recovery is uncertain and you are unable to communicate your own wishes. A living will also provides for the appointments of a guardian or health care surrogate, which is a person you designate to make medical decisions on your behalf in the event you are unable to make those decisions for yourself.

You should address a number of possible end-of-life care decisions in your living will, such as:

  • Whether you would like to be resuscitated if your heart was to stop beating.
  • Whether you would like to be placed on mechanical ventilation if you’re unable to breathe on your own.
  • Whether you would like to be tube fed intravenously or via a tube in the stomach if you were unable to consume food normally.
  • Whether you would like to be placed on dialysis to remove waste from your blood and manage fluid levels if your kidneys no longer functioned.
  • Whether you would want infections to be treated aggressively near the end of your life, or if you would rather let infections run their course.
  • Whether you would prefer to die at home, get pain medication, or avoid invasive tests or treatments to keep you comfortable and manage your pain.
  • Whether you would like to donate your organs or body for others or scientific study.
  • Like any will, a living will can be revoked at any time by destroying it or by communicating to a witness, an attending physician or other health care professional that you wish to revoke it.

What is a Health Care Proxy?

A health care proxy is a legal document that allows you to appoint someone to make medical decisions on your behalf in the event you are unable to make your own decisions. One or more alternate individuals can be selected in the event your first choice proxy is unavailable or unable to serve as your health care proxy. You must choose your proxy carefully since they will be acting on your behalf and will be the person carrying out your medical wishes. After appointing your proxy, it is important to discuss your wishes with them about your medical care, including resuscitation, artificial nutrition, and hydration, along with personal goals for quality of life. By having knowledge of your wishes, it will assist them in making decisions with your medical team and provide comfort to your family and friends who know any decisions made were based on your own personal values and wishes.

Why Should You Have a Living Will or Health Care Proxy?

The Terri Schiavo case demonstrates the heartache, frustration, and legal blockades an individual can face without having some type of legal directive to determine your end-of-life decisions. It also reveals the uncertainty of not knowing what a person would really do if they were able to make their own medical decisions. Living wills and health care proxies provide you with an opportunity to stipulate how you want your wishes to be executed. They allow you to choose the person to make those decisions and ensure that they are not challenged for making those decisions. They also provide your family and loved ones with closure knowing that your wishes were followed.

Terri Schiavo reminded us that tomorrow is never guaranteed. With the proper planning, you can prepare for the worst case scenario to ensure that you don’t suffer physically and your loved ones don’t suffer from the emotional burden of guessing what choices you would want them to make.