Online service allows quicker access to advanced directives

SUTTONS BAY – No matter which side you sympathized with during the Terry Schiavo controversy, one thing was tragically clear: There was no written document detailing her wishes for medical care.

Advance medical directives do just that. One type, often referred to as a “living will,” is a written document that expresses your wishes concerning treatment should you become terminally ill or incapacitated. The other type is a medical durable power of attorney, a document that states who has the right to fight for your wishes when you are unable.

Suttons Bay lawyer Stuart Hollander, who specializes in estate planning, says recent requests for him to speak about advance medical directives on a local radio show and for an area political group were indicative that issues surrounding life and death were more on people’s minds.

“Despite my longstanding interest in advance care planning, I had not had such requests before,” says Hollander.

He says the first step in educating people about a medical directive is making them aware of the necessity of such a document.

“The tragedy of Terry Schiavo forced younger adults to recognize that ‘it’ could happen to them, too,” says Hollander. Creation of such a document is very important; however, it doesn’t do any good if it’s not available to medical personnel when they need it.

Hollander says he’s been involved in emergency situations with the conversation going something like this: “We had you prepare a patient advocate designation for us. My wife is in the hospital. The hospital is asking for the document and we can’t find it.”

“I am very aware of the storage and delivery problem,” says Hollander, which is why he founded, an online medical service that makes documents relating to medical wishes as easy to retrieve as your online bank statement.

“After all, the best directive in the world is useless if it doesn’t get to the hospital when needed,” says Hollander.

“We took advantage of the technology that the Internet presents,” explains Jon Roth, a local web designer who co-established the site with Hollander.

As it currently works, subscribers to submit documents they would like uploaded to the system. Some documents can be generated online, and the system will be even more self-service oriented by December. Subscribers are given a bright orange wallet-sized emergency medical card with a personal identification number printed on it. In the case of a medical emergency during which one is unable to communicate, hospital personnel can access the documents containing that person’s medical wishes and see to it that they are carried out.

Medical directives are the most commonly stored documents. Subscribers may also store medical records, organ donation documents, limited powers of attorney, and other related documents.

While this has been a reliable model since the service launched in 2000, Roth says, the service is currently upgrading its offerings-giving subscribers the ability to store additional health-related information and the ability to give more people access to it. Subscribers will also be able to print out their own medical emergency cards.

Hollander understands that realizing the need for an advance medical directive and then making it easily accessible to medical personnel is often a gradual process, but he hopes that more people will see the ease and speed the Internet can provide.

“It seemed to me that the Internet would come to the rescue,” he adds. “Now people didn’t have to carry directives with them or make elaborate arrangements with family; all they had to carry was a wallet card. It seemed an obvious solution to the delivery problem.”

There are other sources for advance medical directives. Munson Medical Center offers “Five Wishes,” which Hollander describes as an “adequate document,” as part of its advance care planning program. Estate planning lawyers are another alternative.

“The medical directive is always a part of an estate plan,” says Hollander. “The rub is that many young people don’t have sufficient assets to require an estate plan, don’t see the lawyer, and so don’t have a directive.”

In the end, it doesn’t matter what age you are, but that other people know your wishes when it comes to medical treatment. It’s becoming simpler to make those wishes known to your family and hospital personnel. The Internet can get it all done faster and easier than ever before. BN