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Doctors push for broader use of living wills

Death, like taxes, is inevitable. Less sure is how death will come to any given individual. That can make it easy for folks in New Jersey to relegate the issue to the back burner of life. But sooner or later, the issue has to come to the fore and if an individual is incapable of making crucial care decisions for him or herself, who will?

Whatever one chooses to call it; a living will, advanced directive or advance care plan; the objective of this tool of estate planning is to make audible and amplify a subject that is often considered too unmentionable to broach. By holding the conversation with loved ones now and creating a living will, a person creates a bridge that minimizes questions that might arise later about critical care decisions that affect them.

Doctors understand the value of living wills and in some states they are launching formal efforts to expand that understanding and thus boost the numbers of people with advance care plans in place. Wisconsin is one.

According to statistics, only about 20 percent of Wisconsin residents have taken the step of designating a healthcare power of attorney for themselves. That compares with 61 percent of doctors in the state. Nationally, the number of people with a living will is estimated at only 30 percent.

To change things in the Dairy State, the state's Medical Society is mounting a statewide campaign. The plan is to train nurses, social workers, chaplains and other non-physician health professionals on how to facilitate the delicate discussions that need to be held for advance care planning. Some $160,000 has already been raised from various health systems and nonprofit organizations and fundraising continues.

Organizers say the first targets of the campaign will be middle-age patients who already have life-threatening conditions. Society officials say this addresses two realities in healthcare today. One is the fact that so many people with chronic conditions haven't had the necessary conversations about care and then they go to the hospital. The other is that when such patients show up at the hospital doctors, lacking any other information, are required to default to aggressive treatment.

That may not be what's best, or what the patient wants. But without an advanced directive, doctors say they have no choice.

Source: American Medical News, "Wisconsin doctors get support to help patients complete advance directives," Kevin B. O'Reilly, April 30, 2012

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