As we go to press, Terri Schiavo is starving to death in Florida. With the assistance and approval of the Florida State Court system and the Federal Court system, Terri’s estranged husband is being allowed to kill his disabled, non-terminally-ill legal wife, who can no longer speak for herself because she has been denied physical therapy for over a decade, while his common-law wife and their two children stand by his side.
I can’t explain what is wrong with Florida law that would allow this to happen. However, this spectacle highlights the need for all of us to express our wishes, in writing, before accident or illness renders us unable to communicate.
First, under Oregon statutes an unconscious patient is presumed to have consented to artificially administered nutrition and hydration. Over the family’s objections, an Oregon-licensed doctor, with concurrence of only one other doctor can legally withhold or withdraw artificially administered nutrition and hydration from a patient who is deemed to be in one of the following conditions: 1) permanently unconscious, 2) terminally ill, or 3) in the advanced stages of a progressive illness that will eventually be fatal.
In 1989, the Oregon Legislature passed the current statutes (ORS 127.505 to 127.660) that provide a means by which a person can document his own decisions about medical care, and can appoint a trusted individual to be his health care representative and to speak for him when he cannot speak for himself. Doctors and other health care professionals are required by law to follow the patient’s directions as they are expressed in the Advance Directive, and abide by the health care representative’s instructions.
The Advance Directive (FKA Living Will) has two main sections. The health care instructions section allows the potential patient to give detailed instructions to his doctors about what is to be done or not done when certain conditions exist. For example, in the part dealing with a “permanently unconscious" situation, the future patient can decide whether or not he wants to receive tube feeding.
The other main section of the advance directive allows the future patient to appoint a trusted loved one to act as his health care representative, and either provide the medical care professional with detailed instructions about medical care, or allow him to have a free hand in all decisions pertaining to care when the patient is unable to communicate.
I encourage our clients to fill out and sign advance directives, and provide the forms at no cost.