End-of-Life Decisions: What If It Happens In Your Family?

(3 of 3)

A living will is not a panacea. "It's a piece of paper," says Brandt. "It can't get at all those gray areas that happen every day." It may specify that no "extraordinary measures" to prolong life be taken. But are those measures defined? Is CPR extraordinary? A feeding tube? A respirator? What's more, in an emergency, doctors are consumed with saving lives. In practice, written directives often don't come up.

Nor can a living will always trump a family's convictions. A study published last July in the Archives of Internal Medicine found that 65% of doctors surveyed said they would not necessarily follow a living will under special circumstances, such as intrafamily conflict. Prager recently consulted with the relatives of an elderly woman who had suffered a cerebral hemorrhage and was clearly going to die. Her advance directive specified that no extraordinary measures be taken to save her. But her devoutly Jewish son believed that taking his mother off a ventilator would be murder. Prager's committee, the family members, their rabbi and their doctors decided that the ventilator would extend the woman's life by a few weeks, at most. "We did not feel that her will would be significantly violated," he says. She remained on the ventilator and died soon after.

The intense coverage of Terri Schiavo's experience seems to have made many Americans think, That could be me. Jay Sekulow, chief counsel of the American Center for Law and Justice, which has worked on behalf of Schiavo's parents, doubts that their efforts will motivate more families to take conflicts to court. Instead, he says, "I think people will be much more specific in what they want their medical treatment to be." Indeed, Johanson says that at his hospice, the case is "creating fear in patients that their wishes will not be met"; many are responding by "getting things down on paper." Keith Tighe says he and his brothers have reacted to the news by getting advance directives. A TIME poll last week found that 69% of those surveyed who do not have a living will said the Schiavo case had made them think about getting one, or at least talking with their family about how they would like to be treated in their final days. --By Jeff Chu. Reported by Amanda Bower/ New York, Laura A. Locke/ San Francisco and Maggie Sieger/Chicago

If you're thinking about composing a living will, visit time.com/ schiavo for a listing of online resources to help get you started