Over two months after her death, Terri Schiavo's cremated remains were recently buried in Florida. And while the burial is not an end to her story, neither is it an end to the general public's worries about what would happen to them in a similar situation. Most believe that having a living will protects them from end-of-life turmoil. But instead of helping, they can create a nightmare scenario.
(PRWEB) July 7, 2005 -- Over two months after her death, Terri Schiavo's cremated remains were recently buried in Florida. And while the burial is not an end to her story, neither is it an end to the general public's worries about what would happen to them in a similar situation. Most believe that having a living will protects them from end-of-life turmoil. But instead of helping, they can create a nightmare scenario.
Terri Schiavo laid in what doctors called a "persistent vegetative state" for fifteen years while her husband battled with her parents over whether or not to remove her feeding tube and let her die. Though she had no living will, Michael Schiavo says he promised his wife he would never let her be in a situation where she was kept alive artificially. Her parents believed rehabilitation was still possible. And the battled ensued.
"Obviously, it would have been beneficial for her to have had a living will," says Dr. Ferdinando Mirarchi, an emergency medicine physician in Western Pennsylvania and author of What's the Patient's Code Status? (ISBN 1889014583). But, "people need to know that the living wills that are utilized today have three major problems associated with them. First problem is that they are not individualized towards a patient's medical conditions. The second problem is that that lack informed consent. Meaning that they have no idea what they just agreed too. Lastly and most importantly they are horribly misinterpreted to mean do not treat or do not resuscitate (DNR).”
Much of the problem stems from misinterpretation of typical living wills by medical staff. These forms are generic and often legally driven and therefore do not flow medically. Also, they are often recommended to patients with end stage conditions who have already agreed to only comfort care or hospice interventions. As such when medical staff sees a living will they automatically associate it with a reduced level of care. This is what makes a standard living will dangerous and it will compromise your care and safety.
Most people who create a living will are unaware of this problem and wish to receive care unless they are terminal despite reasonable medical intervention or in a persistent vegetative state as was Terri Schiavo.
Mirarchi became so concerned about patient's lack of living wills and the misinterpretation of them, that he wrote a book to help people solve the problem. In "What's The Patient's Code Status?" he cites a number of cases in which medical personnel improperly interpret living will documents.
In one case, a nurse read a patient's living will, determined her "code status" was DNR, and communicated this to physicians and others. Fortunately for the patient, a physician eventually questioned the reasonableness of the DNR in the patients condition. He rechecked the document and the patient's history and decided to intervene. The patient survived and went home a week later with no further problems. Mirarchi says this is a clear case where a living will was misinterpreted to mean DNR.
To make matters worse, Mirarchi says that attorneys often help create the problem when writing living wills for clients. They "shouldn't be doing it unless it has some sort of physician interaction," he says. "Those forms are 99.9% of the time misinterpreted." He recommends that living wills be created using the forms provided in "What's The Patient's Code Status?" or with the help of an experienced physician.
For a review copy of the book or to set up an interview with Dr. Ferdinando Mirarchi for a story, please contact Jay Wilke at 727-443-7115, ext. 223.
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