Advance Medical Directive

We believe strongly that everyone should have an Advance Medical Directive, what Virginia calls a living will.  This is a form document that is set out at Virginia Code §54.1-2984.  But there are a lot of different parts to it, and some choices that need to be made.  We usually help people with Advance Medical Directives when we do their wills, though we can do them separately as well.

The most important part of any consideration of an Advance Medical Directive is actually not the document; it is the discussion that you need to have with your family members.  In the first case that attracted the most attention — the case of Karen Ann Quinlan in New Jersey in 1976 — the court battle turned in large part on the evidentiary question of whether she had ever told their families something to the effect of “Don’t keep me alive on a respirator.”  If Karen Quinlan had had a conversation with all of her family present to say, “If I am irreversibly brain-dead, let me die,” that wish could have been honored without having to go through a lengthy legal battle.

In the case of Terri Schiavo (this case was in Florida courts, Virginia courts, federal courts and Congress from 1998 to 2005), the judge ultimately found, after a trial with 18 witnesses, that she had expressed a desire to be allowed to die if she was irreversibly brain-dead.  (That didn’t keep politicians from getting into the act, but that’s another story for another time…)

In both cases, a great deal of agonizing litigation could have been avoided had there been an Advance Medical Directive.  But the Advance Medical Directive is not itself enough — it is important that you have a conversation with your family members about what is in the Advance Medical Directive.  It is important that your children hear from your own lips whether you want to be put on a respirator, or whether you want to receive artificial nutrition if you are in a coma.  If this conversation is held before there is a crisis, it can head off many later problems.

This is not merely a theoretical problem for us; many years ago we represented the family of a young woman who had fallen from a third-story window.  She suffered irreversible brain damage, and lingered in a coma for almost 20 years.  It was terribly wrenching for this young woman’s parents and family.

For advice on dealing with end-of-life planning, call us at 434-293-8185.