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47 °F Forecast | Road Cams Wednesday, March 23, 2005 Today's News | Classifieds | Autos | Homes | Jobs | Tempo | Health | Community | Home Delivery SECTIONS Home Page Local News Sports Business Obituaries Life Opinion Tempo AP News Weather Classified Archives Site Map SPECIAL SECTIONS Since We Asked Outdoor Journal Menu Guide How To Guide Health Readers' Choice Real Estate Showcase Real Estate Guide Joy Magazine Homelife Magazine Wedding Guide Passport to the Rogue Valley SHOP OUR VALLEY AutoFinder HomeFinder JobFinder Classified Place an ad TOP JOBS EXTRA Ashland News NIE Personals Movie Times TV Times E The People Volunteer Moving here? eSouthernOregon CUSTOMER SERVICE FAQ's Advertise with us Home Delivery Employment Contact Us Media Kit Oregon Road Conditions & Cams Email Story to a Friend March 22, 2005 A. Peterson, 88, of Medford, does not want her life extended with extraordinary medical intervention. A �Do Not Resuscitate� notice is posted on her refrigerator door. She carries a card in her billfold with similar instructions. Mail Tribune / Bob Pennell Oregon’s citizens can avoid Schiavo dilemma Two forms allow them to define their wishes By BILL KETTLER Mail Tribune The sheet of hot pink paper on A. Peterson’s refrigerator door is impossible to ignore. "Do Not Resuscitate," it says in no uncertain terms. The same message is on a card she carries in her wallet wherever she goes, and on file at both Medford hospitals. "I definitely want to take charge of my own life," the Medford woman says. Peterson, 88, took charge long before news stories about Terri Schiavo prompted many people to think about what kind of medical care they would want if they couldn’t speak for themselves. The Florida woman has lived in a persistent vegetative state since 1990 while her husband and her parents fight over whether to remove her feeding tube. Peterson says it’s important for people to tell family members, friends and physicians about what they want near the end of life, and do the paperwork to make it happen. Advertisement "It’s terrible," she says, "to see people who have gone downhill and can’t do for themselves anymore." Oregon gives people two ways to state their wishes. The Advance Directives form describes the care a person wants to receive during a variety of medical conditions. Physician Orders for Life- Sustaining Treatment (commonly known as POLST), gives specific instructions to caregivers about how to respond during a medical emergency. Peterson’s POLST form is displayed prominently on her refrigerator so that caregivers will see it during any medical emergency. "They have to respect that card," she says. The Schiavo case is an example of what can happen when people fail to make their wishes known, says Dr. John Forsyth of Medford, who served on local medical ethics committees before he retired. "It makes all the difference in the world to have something that says, ‘This is what the person wanted,’ " Forsyth says. Schiavo’s case also shows that end-of-life care is not an issue solely for older people, says Diane Kosmatka, hospice nursing supervisor for Providence Medford Medical Center. Schiavo was in her 20s when a metabolic disorder caused her heart to temporarily stop, which left her with severe, permanent brain damage. "Any of us could have a massive stroke or an aneurysm that could render us incapable of making a decision," Kosmatka says. The four-page Advance Directives form is available at hospitals and many physician’s offices. People describe the level of care they want in four situations — close to death, permanent unconsciousness, advanced progressive illness and extraordinary suffering. The form also designates a "health-care representative" to speak when someone can no longer make their wishes known. Choosing the right person is critical, Kosmatka says. "You need to have an outspoken advocate, someone with like-mindedness," just in case the instructions somehow don’t fit a specific situation. Some people may need to go outside their family to find someone who will support their views, she says. "You need to have an advocate for your views, not their own." Advance directives are more popular in Oregon than many states. A 2001 survey of recently deceased Oregonians indicated that 68 percent had completed advance directives, compared to just 20 percent in other states. The POLST form is generally reserved for older, more medically fragile people, says Dr. Erik Fromme, assistant professor at Oregon Health & Science University and senior scholar at OHSU’s Center for Ethics in Health Care. Fromme says people often make specific elaborate plans for their estate or their funeral but fail to prepare adequately for the end of life. "They mostly just hope it will work itself out." People often resist completing the forms because the act forces them to confront their own death, he says. "You’re making it personal by writing it down. There’s a hump you have to get over to do that. "People are worried they’re going to jinx themselves," he says. "You have to put yourself in the position that you’re extraordinarily ill and can’t speak for yourself. Not everybody is comfortable with that. "There’s some uncertainty in trying to predict how you’d react to things you hope never happen to you." Reach reporter Bill Kettler at 776-4492, or e-mail [email protected] Mail Tribune Home | Local News | Sports | Business | Obituaries | Life | Opinion AP News | Archives | Site Map | Community | Classified Copyright © 1997-2005 Mail Tribune, Inc. All rights reserved. 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