The longtime NPR host Diane Rehm is talking about death. Her new book and upcoming documentary discusses medical aid-in-dying, otherwise known as assisted suicide or death with dignity. She argues that especially in the U.S. we are afraid to talk about end of life issues, until we or someone we know is faced with a terminal illness and painful end. As a trust and estate attorney, I talk to people every day who have put off estate and long-term care planning. More than half of Americans don’t have a will and only 37% have some form of advance directive. At least part of the reason is because people don’t want to think about something happening to them or a loved one.

While a few states have passed laws allowing some form of medical aid-in-dying, most states have not. Understandably, it is a difficult topic which ignites fears of encouraging suicide or devaluing life. However, as medical science keeps improving, it is an issue that will touch many lives. There is much more consensus about allowing people to refuse treatment and get palliative care even if it might hasten death. However, even then, disagreements arise. When a patient cannot speak for himself or herself, family members may argue over care. Sometimes healthcare facilities do not honor a patient’s or family’s wishes, especially if there is family conflict.

In my practice, I encourage clients to make their wishes known to their loved ones and doctors and to take legal steps to implement those wishes through the use of a healthcare proxy and living will. As discussed in a previous post, this is not just about end of life decisions. It is about how you want to live your life. If you have a health condition, you should be talking with your family and doctor about your health goals and expectations for quality of life after treatment. Not everyone will view the risks and rewards of treatment in the same way and it is best to have those conversations beforehand when possible.

I am available to assist with your estate and end-of-life planning.