"Whose Life (and Death) Is It?" an Oct. 23 forum devoted to taking control of medical end-of-life decisions, was the third in a series of such forums sponsored by a coalition of Northwest Philadelphia organizations: Weavers Way, Northwest Village Network, East Falls Village, Ralston My Way and First United Methodist Church of Germantown. 

These forums grew out of a book-discussion group focused on “Being Mortal,” Atul Gawande’s 2014 examination of what the medical profession actually can and cannot offer at the end of life. The organizers are planning a fourth forum in the spring of 2017.

Local attorney Daniel Ross and Mt. Airy family doctor Linda Good addressed the gathering of about 60 people. Ross emphasized that everyone needs to prepare for the inevitable since none of us is immortal. He recommended that everyone prepare these documents and make sure they are easy for family members to find: 

• A legally valid will.
• A durable power of attorney.
• A living will, in which you specify the medical treatment you want when terminally ill or in a vegetative state, and appoint someone to make health-related decisions when you are unable to. Copies of this document should be kept available at all times, including while traveling.
• A list of beneficiary designations for assets, such as your IRA and life insurance. These designations are separate from your will and should be monitored so that they agree with what you desire.

Ross also explained in detail how various strategies that are publicized to “avoid probate” are in many cases inadvisable in Pennsylvania, where probate is relatively quick and simple. Such strategies include joint accounts, “pay-on-death” accounts and annuities. These strategies can make it more difficult to raise funds for expenses and taxes and often lack flexibility to address unexpected situations. 

Good emphasized the need to control your own medical treatment. She quoted an essay she wrote as a medical student in 1981: “I never lose respect for the capability of my patients to make their own decisions.”

There are supports for the decision-making process. Starting in 2016, physicians have been able to bill for separate end-of-life discussions, and a number of hospitals have hired staff palliative-care specialists.

To assist both family and physicians, Good stressed the importance of making your beliefs known. To that end, she urged speaking up “before, during and after serious illnesses and life-altering diagnoses,” clarifying values with loved ones, and developing ethical wills, putting your values down on paper. She also recommended the educational work of the nonprofit Compassion & Choices (www.compassionandchoices.org). 

She closed with a discussion of medically assisted dying, which is now legal in five states — Oregon, Washington, California, Montana and Vermont.