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Schiavo case surges living will requests

ORLANDO, Fla. - No one wants to be the next Terri Schiavo.

As lawyers and family battle over the severely brain-damaged woman's fate, her saga has served as a wake-up call to many who had been complacent about their own mortality.

People now are scrambling to create living wills and erase any doubt about the medical treatment they want - or don't want - if they can't make decisions on their own.

A living will spells out whether doctors should provide life-prolonging procedures - including giving food and water - if someone has a terminal condition or is in a persistent vegetative state similar to the one in which Schiavo has lingered for 15 years.

Lawyers and organizations that deal with medical and aging issues report a surge in requests for information on living wills as well as in designating a health-care surrogate, or someone who can make medical decisions if the patient cannot and who agrees with the patient's philosophy about the kind of life worth living.

Schiavo's situation is "heartbreaking," said Paul Malley, president of Aging with Dignity, an advocacy group. But "it's a good thing if people are learning from the tragedy. ... There's a lesson in this for all of us."

The nonprofit organization has received more than 10,000 requests for living wills this week, or about 40 times the usual number of calls. The demand has led to a two-week delay in getting out the forms, Malley said.

"Our phone lines have been completely lit up," he said.

Lawyers also have seen a spike in calls from clients asking about living wills.

"There hasn't been a meeting I've had with a client in the past month where Terri Schiavo's name hasn't come up," said Robert Wilkins, a Maitland, Fla., attorney who handles living wills.

Living wills and health-surrogate forms can be obtained from lawyers or even bought at office-supply stores. They also are available from the state Agency for Health Care Administration, hospitals and hospices.

People filling out either form, known as advance directives, should have each signed by two witnesses who preferably are not close family members - "somebody who would not have some benefit to gain from you being disconnected," Wilkins said.

The forms from the AHCA, written to comply with state law, require that at least one witness must not be a spouse or blood relative.

Experts recommend that people let their doctors, attorneys and loved ones know they have the forms and where to find them. They also recommend keeping a card or note in a purse or wallet stating the forms have been prepared.

Some people go a step further and file their forms electronically with an online registry.

"Many of the people who do register with us already have advance directives. Their issue is, is anybody going to notice and will people be able to get it? Or will it be in a vault or a drawer or lost, tattered and yellowed?" said Peter Heisen, a retired physician who started Health Directives, a Pennsylvania-based registry in which people pay $18 a year to have copies of their living wills maintained online.

The U.S. Living Will Registry in New Jersey has received more than 40,000 visits to its Web site in the past two days, compared with 600 to 700 a day usually. Experts have mixed opinions about the registries.

Orlando, Fla., attorney Terrance H. Dittmer said he thinks giving copies to a doctor and loved ones would suffice. But Malley, of Aging with Dignity, said "anything that improves the accessibility of advance directives is a good thing."

But experts warn that even a living will won't guarantee that a person's wishes will be automatically carried out. A study published last year by the Archives of Internal Medicine found physicians who said they would make end-of-life treatment decisions inconsistent with advance directives under certain circumstances, such as if family members object.

The U.S. Supreme Court ruled 15 years ago that a terminally ill patient has a constitutional right to decline medical treatment. But it also said a state may impose a heavy legal burden on a family to show a patient had actually consented.

Although state and federal law say the patients' wishes should be followed, "there could be gray areas, especially when there's family disagreement," Malley said.

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