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48 °F Forecast | Road Cams Saturday, December 11, 2004 Today's News | Classifieds | Autos | Homes | Jobs | Tempo | Health | Community | Home Delivery SECTIONS Home Page Local News Sports Business Obituaries Life Opinion - Politics Tempo AP News Weather Classified Archives Site Map SPECIAL SECTIONS Since We Asked Outdoor Journal Menu Guide How To Guide Wellness Connection Readers' Choice Real Estate Showcase Joy Magazine Homelife Magazine Wedding Guide Passport to the Rogue Valley EXTRA Newspaper in Education Personals Movie Times TV Times E The People MARKETPLACE Find a Car Find a Home Find a Job Classifieds Place an ad eSouthernOregon Automotive Communities Entertainment Publications Recreation Calendar CUSTOMER SERVICE Frequent Questions Advertising Information Home Delivery Employment Contact Us Media Kit Network Affiliate Oregon Road Conditions & Cams Email Story to a Friend October 27, 2004 Medical ethicist shines spotlight on end-of-life issues By BILL KETTLER Mail Tribune A Michigan medical ethicist visits Ashland this week to teach people how to guide their friends and neighbors through end-of-life decisions about medical care. Most folks, if they think of death at all, imagine slipping away in their sleep, or falling over dead with a heart attack, of fading away quietly in the company of loved ones, Jane Hinnen said in an interview Tuesday. Unfortunately, most of us will face hard decisions late in life about what kinds of medical care to seek and when to acknowledge the inevitable end, she said. Many of us may also have to make those choices for a spouse or parent or loved one who can’t speak for themselves. Talking about treatment options long before any choices must be made eases the process for everyone, said Hinnen, a nurse who helps families through end-of-life care issues. "It’s the conversations that make it possible for a person’s end-of-life wishes to be honored," Hinnen said. Advertisement Those wishes are typically spelled out in documents known as "advance directives," but the talking is every bit as important as the documents. Getting the talking started is the subject of Hinnen’s four-day workshop, which starts today at Trinity Episcopal Church. Hinnen will teach six men and 30 women how to facilitate those conversations, not just how to fill out an advance directive. She teaches an approach called "Respecting Choices," developed by a Wisconsin hospital to encourage people to choose the care they want at the end of life and to make their wishes clear to those who might have to speak for them. After the training, each participant will contact groups in the community to encourage people to make their end-of-life wishes known. "You have to have a community-wide approach to make this work," said Hinnen, 54, who travels the United States teaching about end-of-life care. She was invited here by the Southern Oregon End of Life Coalition, a group of health-care and hospice workers who saw the need for their patients to do better late-life planning. "The biggest problem for everybody who works in this field is people who come into hospice care or acute care without preparing for what their choices are," said Sarah Seybold, a retired nurse who helped arrange Hinnen’s visit. The coalition won a grant from the Robert Wood Johnson Foundation to cover Hinnen’s expenses and training materials. While Hinnen acknowledged that most Americans shy away from talking about end-of-life issues, she said it’s "a little simplistic" to say Americans refuse to accept death. "Our systems are geared more toward the living than the dying," she said. "The health-care system is set up to treat patients aggressively." Oregonians generally use advance directives far more than people in other states. A 2001 study of recently deceased Oregonians indicated that 68 percent had completed advance directives, compared to just 20 percent of adults across the United States. That still leaves one in every three deceased Oregonians who provided no instructions for survivors. Hinnen said in the Wisconsin hospital where "Respecting Choices" was developed, 86 percent of the patients who died had prepared an advance directive, and 95 percent of those patients had their wishes upheld. Hinnen said talking about end-of-life care encourages people to decide where they stand on extreme measures such as life support, and sharing those thoughts with loved ones lightens their burden if they have to speak for a loved one. "I can’t tell you how many times I’ve heard ‘I don’t want to be the one who pulls the plug on Mom,’ " she said. If that mom had told her children beforehand her feelings about life support, her children would know where she stands, Hinnen said, and that would help them speak for her if she couldn’t. Hinnen said encouraging the dialogue requires a high degree of communication skills, a thorough knowledge of end-of-life law, and a sense of each individual’s spiritual and religious background. "It’s a learned skill," she said, "to shepherd people through the conversation." Reach reporter Bill Kettler at 776-4492, or e-mail [email protected] Mail Tribune Home Local News | Sports | Business | Obituaries | Life Opinion - Politics | AP News | Archives | Site Map E Southern Oregon | Classified Copyright © 1997-2004 Mail Tribune. All rights reserved. Privacy Policy | Terms & Conditions Website Feedback ADVERTISERS A D V E R T I S E R S SPECIAL SECTIONS Auto Finder Job Finder Home Finder Joy Magazine Homelife Magazine Tempo Readers' Choice Real Estate Showcase Since We Asked Outdoor Journal Moving to Southern Oregon? Volunteer Opportunities