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Saturday, October 25, 2003 - Page updated at 12:00 A.M.

Living wills can eliminate disputes

By Dru Sefton
Newhouse News Service

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Terry Schiavo's case reportedly has revived interest in living wills and advance medical directives to try to spare families the torment that hers is experiencing.

"If only she'd had her wishes in writing, everyone would have known what she herself wanted," said James Herzog, spokesman for Aging With Dignity in Tallahassee, Fla.

Herzog said the nonprofit has answered more than 2,000 orders in the past week for its "Five Wishes" workbook. In a normal week, he said, there would have been 200 orders.

The 12-page document lets an individual name one person to oversee care if he or she is incapacitated (called "durable power of attorney for health care") as well as specify which medical treatments are permissible.

Herzog said the $5 document has been distributed to 3 million Americans and is legally recognized in 35 states.

The number of Americans who have living wills is difficult to determine.

"I'd say only 10 percent to 20 percent of my patients do," said Anthony Komaroff, a physician and Harvard University medical professor. "That's all patients, including those who are sick and healthy as can be."

Komaroff is editor in chief of Harvard Health Publications, which just released "A Guide to Living Wills and Health Care Proxies." (For more information, go to

An individual without a living will risks ending up in Schiavo's circumstances, with loved ones at extreme odds over her fate, experts agreed.

Partnership for Caring provides a toll-free, 24-hour hotline (800-989-9455) as well as downloadable living-will forms for each state on its Web site,

Karen Kaplan, the group's president, pointed out that the documents are unique. While one person may not want to be kept alive, another may choose to do just that.

"My own document says I want a full-court press, just as long as there is any hope of my having a meaningful life," Kaplan said. She's had long conversations with her proxy, her son, about it.

The U.S. Living Will Registry in Westfield, N.J., recently has been receiving about 10 times the normal volume of hits on its Web site and a "significant number of callers," founder Joseph Barmakian said.

The registry ( is a free depository that makes signed living-will and organ-donation documents accessible 24 hours a day to health-care professionals and family. It also offers forms for all 50 states.

Barmakian, a physician, got the idea in training. "I'd run across people who'd say, 'Grandma has a living will, but we don't know where it is.' "

He founded the registry in 1996. Currently about 10,000 documents are held. It is funded by health-care providers.

Barmakian said anyone over 18 should do three things: Discuss health-care wishes with loved ones, put those wishes into document form, and be sure to keep the form updated and accessible.

"It may not be easily found at the moment you need it, when your family may be shocked or in a panic" over your medical situation, he said.


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