Exploring Human Potential

Amedisys Chief Medical Officer, Michael Fleming MD, endorses End-Of-Life Health Decision Planning On The Anniversary of Terri Schiavo’s Death.

Posted on | March 31, 2011 | No Comments

“It may seem daunting to talk about end-of-life health care preferences; however, not having this conversation with loved ones is just as daunting when you consider the negative emotional impact on those who have to make decisions for their loved ones,” said Dr. Michael Fleming, chief medical officer of Amedisys. “This is a heart-wrenching decision for a loved one to make, and I have seen too many families struggle under this burden. We can free our loved ones by making our wishes known in advance.”

Dr. Fleming’s statement comes on the sixth anniversary of Terri Schiavo’s death and the end of the seven-year legal battle over the 41-year-old Florida woman’s end-of-life care. Without documentation of this young woman’s wishes concerning her own health care treatment, her family – and ultimately the court – was left to decide for her.

Countless families across the country have found themselves in similar situations, burdened with making difficult end-of-life health care decisions for loved ones of all ages. Much of this could be prevented if people let their loved ones know their wishes in an advance directive, also known as a “living will” and health care power of attorney.

“While all Medicare-participating health care facilities are required to inquire about and provide this information to patients under the Federal Patient Self-Determination Act, it is hard to imagine having a meaningful advance care planning conversation at the time of admission. And, this law doesn’t help healthy young people who become incapacitated unexpectedly,” said Nathan Kottkamp, J.D., partner with McGuireWoods in Richmond, Va. “Therefore, it is important for all people – young and old, healthy and sick – to discuss and document their end-of-life care with their loved ones and health care providers today.”

According to a 2006 Pew Research Center study, 70 percent of Americans have not completed an advance directive. And, while only 30 percent of Americans have documented their wishes, 78 percent said that palliative care and end-of-life treatment should be discussed, according to a survey released March 8 by the Regence Foundation and NationalJournal.

To address this significant gap, Kottkamp founded National Healthcare Decisions Day (NHDD) in 2008. Every April 16th since, this annual initiative, which is driven by local, state and national organizations, has raised awareness of the importance of advance care planning and helped countless Americans become more empowered about their health care. Empowering people to decide and voice how they wish to be treated at the end of life is a top priority for health care experts at Amedisys, a national home care and hospice provider and supporter of NHDD 2011.

An advance directive can alleviate the burden of making end-of-life decisions for a loved one. This legal document details a person’s health care wishes in the event that the person becomes unable to speak for him or herself. Advance directives may indicate a person’s health care power of attorney – the person who makes decisions on behalf of an incapacitated loved one – and a “living will” that documents the types of medical procedures someone wants, or does not want, at the end of life. These end-of-life treatment preferences could include: the use of artificial nutrition and hydration, the use of ventilators or other life support resources, and preferences regarding resuscitation or CPR.

“Free resources are available to help you discuss your wishes and then to put your wishes in writing, and to help you avoid placing an unintended burden on those you love,” Kottkamp said. “On behalf of everyone – from coast to coast – who is involved in National Healthcare Decisions Day 2011, we urge you to take time on April 16th to have these important conversations with your loved ones.”

After having these discussions with loved ones, Dr. Fleming recommends that individuals have a similar conversation with their health care providers.

“Everyone deserves top-quality, compassionate care throughout their life,” Dr. Fleming said. “We have a say in how this health care is delivered, including the nature and level of treatment we receive at the end of life. It is up to us to make our wishes known in advance, to ensure we receive the care we desire if we become unable to speak for ourselves.”

To learn more about NHDD and related educational events held across the country, or to access free resources online to develop an advance directive, visit To learn more about available end-of-life health care services and support,


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