If you’ve ever had a family member in a terminal state, you know the the heart-wrenching decisions that must be made about how – or whether – to treat them. If our loved one isn’t able to speak for themselves, how do we make those decisions?

Many people have what’s called a “living will” – known in California as an advance directive - a document that spells out how they want to be treated in the event of extreme illness or accident. But with advances in medical care over the past few years, end of life decisions have acquired many more shades of gray, and the original document may no longer be sufficient. Perhaps your family members know that you wouldn’t want to be kept alive by artificial means if there’s no chance of having a meaningful life going forward. But what exactly does “meaningful life” mean to you? Would you want to be kept alive if you could no longer walk, garden, communicate, feed yourself?

These are questions of personal values, beliefs and fears that must be discussed between family and physicians in order to ensure that your “living will” covers the variables that could affect those decisions.

Have you had that conversation with your physician? With your family? Who would you trust to carry out your wishes?

GUEST

Felicia Cohn, PhD, bioethics director for Kaiser Permanente of Orange County