Preferences regarding life-sustaining treatment

How can you have your preferences regarding life-sustaining treatment known?

There are three key strategies:

1. Discuss your feelings with your physician, family and friends. The more detailed the discussion, the better. Talk about your goals. Do you want to live as long as possible no matter what? Are you more interested in being comfortable? Do you want aggressive medical intervention only when you have a decent chance at a meaningful survival? What is "meaningful" to you?

2. Write a living will. You might specify what treatments you would desire if you were comatose, terminally ill or irreversibly demented. Be sure to give copies of your living will to your doctor and family members. That way, it will be available when you need it.

3. Appoint a health-care proxy. This is someone you entrust with making decisions for you should you become incapacitated. (If you regain your faculties, of course, control of your medical care reverts to you.) To fully prepare your proxy, be sure to discuss your goals and feelings explicitly.

The smartest approach may be the combination of all three-talking things over, preparing a living will and appointing a health-care proxy. By leaving written instructions, you lessen the burden on your proxy. If the doctors try to ignore the dictates of your living will -unfortunately, an all-too-common event your proxy can call them on it.

All 50 states allow some form of "advance directive." Unfortunately, the rules and even the terminology vary. To learn your state's requirements, or for more information about living wills, contact Choice in Dying, 200 Varick St., New York 10014. 800-989-9455. http://www. choices.org.

Several weeks before he died, my father was hospitalized. Despite treatment, his condition only worsened. He developed painful bedsores. He hated the food. We could only visit a few hours a day.

Fortunately, he had prepared a living will. In accordance with his wishes, when it became clear that further medical intervention would be futile, we brought him home. He spent the last two weeks of his life on a hospital bed we had set up. He died peacefully, holding my mother's hand.

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