difficult but important conversations

Now that the death-without-dignity demise of Terri Schiavo has been eclipsed by the death-with-enormous dignity of the Pope, it's time to sit down with loved ones and have that all-important conversation. Actually, if you haven't done so already, it's also time to get some legal paperwork in place.

Do you have a health proxy -- a person responsible for making health decisions for you, should you become incapable of making those decisions yourself? If not, find someone, or better yet, find two people, a primary person and an emergency backup should the primary person not be available. What if you can't think of the perfect person? (You're single, you don't want to burden people, etc etc). Pick someone anyways -- pick the best person you can. This designation is revocable, so you can change it if someone better comes along. You need an advocate. And you need someone who can carry out your wishes, regardless of what they'd want for themself.

Don't forget to ask the designated people before designating! Some people might feel uncomfortable in this role. And don't forget to reveal the identity of your health proxy to others -- it can be a convenient thing to know.

Are you done? No. Read on.

Do you have a living will -- a set of instructions about what should happen to you at the end of your life? There are no right answers, of course -- each person has different desires. But consider some of these situations:

• You are in an irretrievably hopeless, persistent vegetative state, and some amount of time has passed (Three? Six? Twelve? Months? Longer?) Several doctors have all reported that there is no chance of recovery. What measures would you want taken? Some level of artificial support (breathing, feeding, water)? All levels? None?
• You are in this state, your life support is removed, and someone wants to put it back. Is that ok? Desirable? Undesirable?
• You are in miserable, constant pain, and will be for the rest of your life.
• You can no longer distinguish between your loved ones and strangers.
• You cannot enjoy the company of others -- you have no connection to any living being in the world.
• Are there any situations under which you want to be resuscitated? Are there situations under which you'd be mad if you were resuscitated?

If you have not written these instructions and given them at least to your health proxies, please do so soon. This is a legal document. You can do it yourself or get a lawyer involved. But the document does no good if no one knows of its existence.

Have you talked to your loved ones about what you want? This is also an important step. The more that your loved ones hear from you about your wishes, the less likely they are to wonder what you want. And the less likely they are to argue about it when you are no longer able to tell them. Find a time to talk about it and start talking. And while you're at it, ask your loved ones what they would like.

Please -- get talking and get writing. It's the best way to insure that your wishes, and your wishes alone, are carried out.