End-of-life planning is easier than you think

Disclaimer: The information provided is not legal advice but general information on legal issues commonly encountered.

Maybe you remember this story:

Terri Schiavo experienced a cardio-respiratory arrest in 1990, significantly cutting off the flow of oxygen to her brain. She remained in a vegetative state for 15 years, receiving nutrition and hydration through a feeding tube. Because Terri had never recorded her wishes in a legal document, her husband and parents battled against each other, ultimately leaving the decision in the hands of the Supreme Court.

Could Terri’s story become your story? Yes, it is possible.

According to the law, your spouse, parents and children are not automatically authorized to make decisions on your behalf if you are suddenly unable to speak for yourself. Those decisions will be left to a judge if you haven’t made the proper preparations.

Want to save you and your family from this traumatic experience? Write down your wishes ahead of time.

Break through the jargon

It’s understandable to feel overwhelmed at the thought of making your end-of-life wishes. Don’t worry – it’s easier than you might think. Start by familiarizing yourself with two legal terms:

• A personal directive – also known as an advance health care directive – is the document that provides your family members and health care provider with explicit direction regarding medical intervention if you become incapacitated by an injury, an illness or old age – or if you want to set specific limits on your treatment. For example, if you suffer cardiac failure and your life cannot be sustained without invasive and continuous treatment, you can state whether or not you wish to be resuscitated.
• A personal directive also names your substitute decision maker, the person authorized to represent you or make decisions in your place. As the person to whom you’ve committed for a lifetime, your spouse is the most qualified person to speak on your behalf as a substitute decision maker.

Using these terms as a foundation, you and your spouse can set yourselves up for success by making a plan.

Get started today

1. Understand your mortality. Life can take a dramatic turn in an instant – no matter how hard you work to protect your health. Scripture tells us that "There is a time for everything, and a season for every activity under heaven: a time to be born and a time to die, a time to plant and a time to uproot" (Ecclesiastes 3:1-2).
2. Research the rules. Each province has different rules and regulations for personal directives. If desired, speak with a lawyer for further clarity.
3. Reflect on your values. Canadian Hospice Palliative Care Association suggests reflecting on health-related decisions made by people you know and how you felt about their personal decisions. This will help you to familiarize yourself with end-of-life treatment options and choose options that resonate with you.
4. Talk to your spouse. Your spouse knows far more about your values than a doctor or health care provider would. "Medical practice in (the) hospital has become the practice of strangers on strangers," say John B. Dossetor, University of Alberta emeritus professor of bioethics, and Robert S. Fraser, chair of Alberta Medical Association’s Joint Ethics Committee, in a shared report. Since your spouse will represent you as your substitute decision maker, be as specific as possible when declaring your wishes. "To really succeed, you should explain in detail to your (substitute decision maker) what you mean by what you are writing," says Dr. Michael Gordon, professor of medicine at the University of Toronto.
5. Consult your doctor. "Discuss with your physician what terms you should use to achieve your goals and to avoid misinterpretation," Dr. Gordon adds. In an interview with The Lawyers Weekly, Halifax medical lawyer Jeanne Desveaux emphasized that doctors rely heavily on clear terminology. "What is advanced life support to a patient might mean oxygen," she says. "To a doctor, it might mean renal support."
6. Download a form. You can find personal directive forms on your province's website.
7. Make several copies! Keep copies of your document in a secure place, and consider giving one to your doctor to include in your medical records.
8. Update it each year. Your views and wishes may develop over the years, so keep your spouse in the loop and make sure they update their paperwork as well.

Reference to the individuals and organizations quoted does not constitute a blanket endorsement of either the individuals’ external work or their respective organizations.