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Revised: 2/16/15

Americans are independent, they like to control their own lives. However, they rarely think about the final phase of life and, as a result, often are unprepared to face heart-wrenching decisions. Marilyn Webb suggests in her book The Good death; The New American Search to Reshape the End of Life that while a good death was once a matter of sheer luck, now it "has more to do with the decisions we-and our healthcare providers-make about our medical treatment and terminal care…" Most people first deal with end-of-life issues not with their own medical crisis but with the death of a relative or friend.

The Morrison Family

Tim and Nancy Morrison are in their 30's with two young children. Work and their children's activities fill their days. But a phone call from Tim's mom gives them pause. She tells them that after a two-year bout with cancer, Tim's boyhood friend Dave just died. Tim is shaken to learn that Dave stopped his cancer treatment several weeks ago. Tim couldn't understand why Dave gave up the fight. He had never been a quitter before, and it was hard for Tim to accept that his friend had stopped the treatment. Nancy, on the other hand, reflected on how sick Dave had been with the cancer treatment. She could imagine that some people, like Dave, would finally decide that it was no longer worth it. They talked about what each of them might have done in Dave's position. To their surprise, they discovered they actually had very different views about how they would make this kind of decision. Nancy and Tim went to bed that night thinking of Dave and his family and wondering, "What if..."

Both Tim and Nancy had lost grandparents, but they had never thought about their own deaths until Dave died. His death prompted them to think about and discuss their views about dying. Realizing that one of them might have to be the decision-maker for the other, they talked over their own beliefs about what is important at the end of life.

Why, you might ask, should young, healthy people like Tim and Nancy bother with end-of-life planning when they have no need now?

There are several reasons. First, "advanced care planning" allows you to think about important issues when you don't need to make immediate decisions or aren't under great emotional stress. It's also good to know that your loved one understands your wishes should you unexpectedly become unable to speak for yourself. If you become the decision-maker, you don't have to guess what your loved one wants; you're prepared to act based on what your know. Finally, if you and your family have different views, advance care planning can help avoid serious family conflict.

All states recognize at least one type of advance directive as a legal document. There are two main types, but the laws of each state may vary on wording and restrictions. Medical Power of Attorney - also known as a Durable Power of Attorney for Health Care ( or Health Care Proxy), this lets you choose someone to make your healthcare decisions if you cannot. Living Will - This document tells you doctors how you want to be treated if you suffer from a terminal illness.

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