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Make your wishes known with proxy or living will

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A staff report

The Tampa Tribune

Published: July 5, 2009

Thinking and talking about a living will is a good start, local lawyers say. But too often people think living wills are a complete solution, said James Eggert, a Tampa lawyer who specializes in trusts, wills and estates.

"A lot of people seem to think this is like a black box, that you fill it out and that means they won't end up like Terri Schiavo," Eggert said. But when he starts asking clients about various medical scenarios, clients realize a detailed living will can be a complex document.

Three criteria

Florida law, Eggert said, describes three major criteria governing living wills: persistent vegetative state, end stage condition and terminal condition.

For example, Eggert said, a person may have Alzheimer's that a doctor diagnoses as end stage, meaning there is no reasonable chance of recovery. But in the meantime, they may contract pneumonia, which is treatable.

"Do you let that pneumonia run its course and maybe you survive it and maybe you don't, because you're in an end stage?" Eggert said.

There isn't any standard form that will answer all the possible questions that could arise as medicine advances, he stressed. People should consider naming a health care surrogate - a trusted and objective person who would make medical decisions for them if they become incapacitated.

Doing so in writing decreases the chances that there will be a major dispute if the living will is challenged in court. The more precise, descriptive and current the language in the document, the better, Eggert said.

Health care surrogate

A surrogate is the person you appoint to make decisions about your medical care if you become unable to make those decisions yourself. Your surrogate can be a family member or a close friend whom you trust to make serious decisions.

The person you name as your surrogate should clearly understand your wishes and be willing to accept the responsibility of making medical decisions for you.

You can appoint a second person as your alternate surrogate. The alternate surrogate may act on your behalf if the first person you name as surrogate is unable, unwilling or unavailable to act for you.

The law requires that you sign your Designation of Healthcare Surrogate in the presence of two adult witnesses, who must also sign the document. At least one of your witnesses must not be your spouse or a blood relative.

One of the strongest reasons for naming a surrogate is to have someone who can respond flexibly as your medical situation changes and deal with situations that you did not foresee. If you add instructions to this document, you might unintentionally restrict your surrogate's power to act in your best interest.

Talk with your surrogate about your future medical care, and describe what you consider to be an acceptable "quality of life." If you want to record your wishes about specific treatments or conditions, you should use your Florida Living Will.

A Florida Designation of Healthcare Surrogate can be revoked if you no longer want your designated surrogate(s) to make decisions on your behalf. State law permits you to revoke your document in the following ways:

•Through a signed and dated writing showing your intent to revoke;

•By physically destroying the original, or having someone destroy it for you in your presence;

•By orally expressing your intent to revoke;

•By executing a new Designation of Healthcare Surrogate that supersedes the older document.

You should also be aware that if you name your spouse as your surrogate and your marriage is subsequently dissolved or annulled, your former spouse will no longer be your surrogate unless you provide otherwise in your Florida Designation of Healthcare Surrogate.

Information from Tribune archives and www.caring info.org, which is overseen by Caring Connections, a program of the National Hospice and Palliative Care Organization, is a national consumer engagement initiative to improve care at the end of life.

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