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The Most Important Conversation You Don’t Want to Have

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Jennifer Balmos

By Jennifer Balmos

When we think about our close friends and family, we can usually name their favorite sports team, favorite type of food and likely, their political affiliation. Yet many of us do not know something much more important about those closest to us – the way they wish to spend the end of their lives.

Admittedly, discussions about life-sustaining treatment and hospice care are not the cheeriest. But avoiding the conversation because it is uncomfortable can result in family members being forced to make life-and-death decisions without any guidance. It also opens the possibility to long-term division within a family when siblings disagree on the best course of action.

This doesn’t have to be the case. Proper planning, while emotional, gives peace of mind to all involved by naming a person to make decisions for the patient, as well as laying out what the patient would want to happen so that the agent is not making decisions in a vacuum.

Consider a husband and wife who are in a car accident. Both are badly injured and are in comas. The couple has a nineteen-year-old son. With both spouses incapacitated, Texas statutes provide that the couple’s adult child will make decisions regarding life-sustaining treatment in concert with a physician. Even with a strong family network, this is an incredible burden to place on such young shoulders.

With a properly-drafted Medical Power of Attorney, however, the couple could designate any adult to make these decisions, saving their son from the stress of trying to determine their wishes in the middle of an emergency. Texas also allows individuals to nominate a second agent, if the first is unavailable or unwilling to serve. This can be vitally important, especially in the cases of married couples, who often designate each other as the primary agent.

Consider an alternative: the husband in our previous example had executed a properly-drafted Medical Power of Attorney along with a Directive to Physicians. He named his wife as his primary agent, and named his sister as the successor agent. He talked to both his wife and sister after signing the documents, and both had copies. His sister knew if – and when – he would want life-sustaining treatment terminated. She also knew that he wanted to be an organ donor, and that he wanted a pastor from his church to visit. Though her role is extremely difficult, the sister finds peace knowing that she is doing what her brother would have wanted. And the family remains united during an extremely difficult time.

Without a doubt, end-of-life conversations are emotionally challenging. But planning ahead is the only way to ensure that the right person is empowered to make the right decision – when so much is at stake. That peace of mind is certainly worth the cost of a difficult talk with family members or trusted friends.

Jennifer practices in Bartonville, and is a member of the National Academy of Elder Law Attorneys. www.balmoslaw.com.

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