Planning for death is essential, UD prof says

Madeline Lambrecht, past president of the Association for Death Education and Counseling

10:30 a.m., May 25, 2005--We plan for weddings, births and retirement. We have long discussions about where we might take our dream vacations. But, according to Madeline Lambrecht, professor of nursing at UD, who also directs the University's Division of Special Programs in the College of Heath and Nursing Sciences, we almost never discuss or plan for our own deaths, the most common and inevitable human condition.

"I think as a society we prepare for many events," Lambrecht said, "but the one that we all face, which is death, is the one for which no advance plans are made. In fact, we seem to avoid all mention of it and have difficulty talking about it."

Lambrecht, who is the immediate past president of the Association for Death Education and Counseling (ADEC), an international nonprofit organization that educates and counsels individuals on death-related issues, said that one way to change this is by educating people about their options. In the aftermath of the national publicity over withdrawing a feeding tube in the Terri Shiavo case, she added that the topic of advance preparation is particularly timely. "I think having a discussion about a living will is one good way to start the discussion," she said.

Emphasizing the need for broader education on the topic, Lambrecht, who was at the annual ADEC conference in New Mexico when Terri Schiavo died on March 31, said that within minutes of Ms. Shiavo's death she was rushed to interviews at two TV stations to address the importance of advance directives.

"The whole case never would have occurred if there'd been an advance directive, and it's very sad it went on as long as it did and that there were so many people involved," Lambrecht said. "We heard from the clergy, the media, the lawyers and the legislators in the courts, but actually the most important voice in all of that was the voice that was not heard--except through someone else--and that was the patient's voice."

Lambrecht, who still serves on the executive board of ADEC, with whom she has been affiliated since 1985, said that the most important legacy the Shiavo case left behind "was the legacy of raising the awareness of the need to discuss one's wishes with family and significant others while you're still well, and then to execute a document that sets forth those wishes."

Lambrecht said that planning for one's own death should begin early. "You need to be 18 to execute a living will, and I think it would be wonderful for a family to sit down and discuss this with their teenage children," she said. "I also think that's probably the best time to go ahead and take one out, knowing that it's not written in stone and you can make changes to it at any time in the future."

Besides needing to know that an advance directive can be changed at any point, Lambrecht said that individuals should know their rights when it comes to putting in the details. "Living wills or advance directives take effect when you yourself are no longer able to say, 'Yes, I want this,' or, 'No, I don't want this,'" she explained, "and an individual can put as much specific information in [the document] as he or she likes. For instance, you can specify that you don't want a ventilator, but that you do want to have an i.v. for hydration."

But, Lambrecht added, it's also important for individuals to know that advance directives aren't only about measures they don't want taken. "A lot of times when people think of an advance directive it's only along the lines of those things they don't want," she said. "But, when you execute an advance directive you also can say, 'My choice is to prolong my life in every way possible.'"

Another point individuals should be aware of, Lambrecht said, is the power of state mandates. "Advance directives are significantly different from state to state, so people should know the rules of the state in which they reside to be absolutely sure," she said.

"I think we all have our own personal beliefs, but by having an advance directive and also a durable power of attorney for health care, you can be relatively assured in advance that your wishes are going to be carried out."

For individuals interested in learning more, Lambrecht suggests visiting [www.caringinfo.org], which, besides listing the rules for every state in the union, does a good job explaining what an advance directive is.

"As technology continues to move forward, we're only going to be faced with more and more ways to prolong life, so we have to consider quality of life," Lambrecht said. "When an individual is executing an advance directive that should be a consideration."

ADEC, established in 1976, is one of the oldest organizations in the field of dying, death and bereavement. Members include mental and medical health personnel, educators, clergy, funeral directors and volunteers. To learn more about ADEC and its services, visit [www.adec.org].

Article by Becca Hutchinson
Photo by Kathy F. Atkinson

E-mail this article

To learn how to subscribe to UDaily, click here.