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Over the Back Fence By HANK HENRY Consider 'advance directive' You may not want doctors to take heroic measures to keep you alive in a medical crisis, but unless you have signed a paper giving them specific instructions, you may not get your wish. A nonprofit group called Oregon Health Decisions has a form called "advance directives" that will allow you to make decisions about how you would want to be treated if an illness or accident should leave you incapacitated and unable to make decisions about your treatment. Ideally, by the time somebody reaches age 40, he or she should have filled out a copy of the directive, and made copies for his or her physician and attorney. Copies should also be placed in the family's safety deposit box, and given to the person chosen to be the person's health-care representative. But in reality, to expect a person between ages 30 and 60 to go to this much trouble is like asking a person to think about death. Most people will say they have never given much thought to the subject. They instinctively believe they will live forever, and worry that just thinking about the alternative might cause something bad to happen to them. They are afraid to tempt fate. But the young are not alone. Many elderly people also fear thinking about a time when they might be standing at death's door, unable to make rational decisions about medical care. You may have told your next of kin that you don't want any heroic efforts to prolong your life, but, unless you have filled out the proper legal document, your wishes might be overridden by a strong-willed relative or even a friend who is determined to keep you alive, no matter what. Nora and I filled out those advance directives about 10 years ago, when I reached the age of 65, but a lot can change in a decade. You may have changed primary care physicians, or your HMO may have made the change for you. You may have contracted a life-threatening disease which hadn't even been discovered back then. No matter whether the changes are large or small, it will pay to keep your advance directives up to date. The first thing to do, even before filling out the form, is to talk to all your family members while you are in relatively good health to make sure they understand your wishes. By doing this you free them from the burden of trying to decide what you want at a time when decisions could be difficult to make. The document gives you the flexibility to specify whether your directives are to continue for a given number of years, or for the rest of your life. You also appoint a "health-care representative" and an alternate to make decisions for you. You cannot appoint your doctor, or an employee of your doctor, or anyone connected with your health-care facility, unless that person was chosen prior to your admission to the health-care facility. This section also allows you to specify whether you should be put on life support or fed by a tube. Another section deals with near-death situations. You can specify whether you want to be connected to life support equipment and tell doctors how to proceed if you are permanently unconscious or unable to communicate. The document also allows you to tell doctors how to proceed if they determine that life support equipment would not improve your condition and cause permanent and severe pain. The advance directives form also explains that a "health-care power of attorney" is any document you may have signed to appoint a representative to make health-care decisions for you. While the document is called a "power of attorney," it does not require an attorney to complete, although some people may want to talk with an attorney as they complete the document. For more information about advance directives, call Oregon Health Decisions, (a nonprofit organization) at 1-800-422-4805, or write them at 812 W. 10th Ave., Suite 203, Portland, 97205. Preparing a document about end-of-life decisions is like checking the spare tire in the trunk of your car. Some people find out that the spare is flat only after having a blowout. Get yourself (and your loved one) an advance directives form and fill it out. Don't wait until your tires are bald. (Hank Henry is a retired Jackson County commissioner and a former radio and television announcer. Call him at 772-9055.) Prime Times front page Mail Tribune front page Copyright � The Mail Tribune 1999, Medford, Oregon USA