- Following is an excerpt taken from a report by FOXNews.com  The (Terri Schiavo's) diagnosis has been a court matter, both in 2000 and in 2002. In the latter year, a Florida judge agreed with four neurologists that Schiavo was in a persistent vegetative state. Brain scans and examinations were conducted in 2002, but no new neurological evaluation has been ordered since, and the medical record has been closed. In a persistent vegetative state, a person is awake but not aware of oneself or the environment, and making only reflex movements.

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This column is about healthy aging. It is everyone’s desire to stay healthy, and as we age, we often are reminded that health is not guaranteed. Even life will end. So, given this understanding and the recent publicity around Terri Schiavo’s life and death, what lessons can be applied to “healthy living?”

Schiavo suffered irreversible brain damage and lapsed into a coma apparently related to an eating disorder that caused a nearly fatal heart rhythm. During the cardiac arrhythmia, her brain did not receive enough oxygen for her to regain consciousness. She persisted for more than 10 years in a “vegetative state” unable to function as a human being.

This tragic case created world-wide attention including public commentary, nightly news attention, legal battles, family schisms, religious interventions, and proposed law changes. A recent editorial in The Wall Street Journal asked, “How can it be morally responsible to let a woman die when there are family members pleading to take on the burden of caring for her?” Dr. Bob Sade, director of the Institute of Human Values in Health Care at the Medical University of South Carolina, has stated: “The question is not what family members wanted for Terri; it is what Terri wanted for herself.” There are important lessons in this sad story for us all.

Life is precious. Life and death are matters of very individual, religious and societal concern. This explains a world-wide concern: individuals and organizations from all points of view know that a life and it’s extinction is precious.

An individual’s future becomes the concern of many when the individual is unable to express his or her opinion about the intensely personal decision to live or die when in a vegetative state.

Quality of life matters to many individuals. Abstract surveys reported that most Americans would not want to be continued in a vegetative state with no hope for recovery, losing all personality and being a tremendous burden to their family, friends and society.

The importance of making a personal determination of care should one become so incapacitated is a clear lesson in this case. Had there been a living will or advanced directive, Shiavo's intentions would have been clear to her family.

Clear communication with friends and family and written comments about these difficult issues are important in guiding family should the unthinkable occur. The Schiavo case spawned many necessary conversations with family and friends about this important issue. 

You can do something about your case. As Dr. Sade has recently pointed out: “Most people do not have an advance directive, despite years of urging and passage of state and federal laws to encourage them. There is a reason for this: Most people do not want to think about their own death or the death of a loved one, much less plan for it. Talking and thinking about one’s own death is simply too threatening and distressing to rank high on a list of conversational topics for most of us. Here are a few things you can do to address the issue:

1) Make your wishes known by talking with your family or doctor or by writing them down, but unless you have a durable power of attorney, a patient advocate does not have legal authority to act for you.

2) One of the many benefits of modern technology is the internet and if one wants more information about living wills and advanced directives, simply go to Google and put in the words “living will.” One of hundreds of resources is https://www.legaldocs.com/htmdocs/livin_st.htm and this and many other similar web-sites will assist you in South Carolina or other state’s laws concerning the simple creation of an advanced directive or living will. Have a living will on file with your family and your attorney. 

3) Appoint a power of attorney with your attorney’s assistance and instruct this person on your wishes.

4) Most hospitals have a form that allows patients to determine a course of action should they be unable to decide for themselves. This is the equivalent of a living will during a planned hospitalization. It cannot be executed if you are unconscious.

Our goal is for you to take the information from this column and take steps of personal accountability to insure healthy living.

Additional Online Resources outside MUSCHealth.com:
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