Quinn: Death and Medical Choices

There's more reason than ever to leave written instructions about the medical care you want if you're unable to speak for yourself. In the wake of the Terri Schiavo case, in which her husband and parents fought over whether to remove her feeding tubes, right-to-life activists have been working on state legislatures. Their objective: requiring doctors and families to keep life support going for patients in a permanently comatose state. If that's not what you want, you need to make it clear.

What's happening?
In 23 states, legislators have introduced versions of a model bill written by the organization National Right to Life. It establishes the presumption that patients in a persistent vegetative state would want continuing life support unless they've left written instructions to the contrary. Public officials could file lawsuits against doctors or relatives tempted to pull the plug. In most states, these bills have gone nowhere. But versions of them have passed in North Dakota and Oklahoma.

Have any states made it easier for families to make life-and-death decisions?
Not since Schiavo. Prior to that case, there was a liberalizing trend, making it easier for relatives to "stand in the patient's shoes" when making life-support decisions. This standard rules in 39 states and Washington, D.C., reports Alan Meisel, whose book "The Right to Die" tracks changes in state laws. That's up from 25 states 10 years ago. Court decisions or sympathetic doctors tend to lead to the same result in most other states, although you can't be sure. "Schiavo alerted people to the risk of government intrusion," says attorney Kathryn Tucker of Compassion & Choices, which supports choice at the end of life.

What can you do?
You have the right to make your own medical decisions. So write a living will and choose an agent to act in your name. If you reject a life on feeding tubes, your written wishes should prevail even in states with must-feed laws. See caringinfo.orgfor free living-will forms. If you'd prefer to be kept alive while in a permanent coma, you'll find a "will to live" form at nrlc.org.

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