The Importance of Establishing Advance Health Care Directives

More than 15 years ago, after lengthy state and federal court battles, Terri Schiavo’s former husband was allowed to instruct the removal of her feeding tube.

In 1990, when she was only 26-years-old, Terry Schiavo suffered a heart attack and then fell into a persistent vegetative state. A highly public battle about her care took place between her husband, Michael Schiavo, and her parents, Robert and Mary Schiavo. Read more about the case here.

At the time, the case garnered national and international attention. Commentary came from actors, the Vatican, members of Congress, then-president George W. Bush and his brother, then Florida Governor, Jeb Bush.

The latter had previously signed a Florida law that allowed himself and Schiavo’s parents to prevent the feeding tube from being removed. While this law was later deemed unconstitutional, greater scrutiny was focused on the issue of advance health care planning.

Terri Schavio was in a persistent vegetative state. Mr. Schavio wanted Terri’s feeding tube removed. However, her parents wanted to keep the tube in place. Each side said they were acting based on what Terri would want.

The ensuing battle between them took years and cost each side immensely in terms of monetary expense, stress and time.

This unfortunate case could have been avoided if Mrs. Schiavo had signed an Advance Health Care Directive earlier in her life, expressing her wishes.

Former Governor and now Presidential candidate, Jeb Bush has again placed himself at the forefront of the issue. At a recent forum, he made statements regarding the Schiavo case and the future relationship between Medicare and advance directives.[1]

Candidate Bush has suggested all Medicare beneficiaries should be required to sign an Advance Health Care Directive as a condition of acceptance into that program. While critics claim that such a stipulation would open Pandora’s Box in terms of the government’s role in end of life decisions, nothing should detract from the importance of such documents.

Whether required for enrollment in government programs or not, it is always a good idea to plan for the future. Schiavo did not see herself suffering from cardiac arrest resulting in the brain damage that required permanent long-term care. The resulting lack of clear direction led to a 15 year legal, and public, opinion battle between her husband and parents.

If Schiavo had estate planning documents—including an Advance Health Care Directive—in place, her wishes would have been the authority during the complicated situation.

Terri would have only received the care that she had articulated in those documents, not what others thought she wanted.

The same can be said for all of us. No one envisions themselves becoming incapable of making their own decisions, but life happens, and failing to plan means your choices may be beyond your control.

In addition, Terri’s young age is another reason that we advise anyone above the age of 18 to consider basic estate planning documents.

[1] An Advance Health Care Directive can be oral, but usually is a written legal document. It expresses a person’s wishes about what should be done if they later become incapable of making their own healthcare decisions. This can range from having healthcare workers undertake all available means to save your life, to just providing “comfort care.” The directive can also allow the appointment of a health care agent to make care decisions if the grantor can no longer do so.

For more information, contact the estate planning attorneys at Abraham & Bauer, LLC.

Planning ahead is a gift to your loved ones!