How about these as conversation starters for your next family/church/social gathering:

  • If you could not make decisions about your health care, who would make them for you?

  • What values do you consider as you contemplate end-of-life issues and decisions?

  • Where do you keep documents and information about your health care preferences? Do you have those documents? Is your family and medical team aware of your preferences?

Sound far-fetched? Not really. These and other significant questions remind us that life is fragile - and that we can begin planning now for the possibility that decisions about our lives may be made by someone other than ourselves.

April 16 is National Healthcare Decisions Day, an initiative to encourage patients to express their wishes regarding healthcare to their families and medical team. It also serves as a reminder for providers and facilities to respect those wishes, whatever they may be.

The Federal Patient Self-Determination Act requires that all Medicare-participating healthcare facilities inquire about and provide information to patients on Advance Directives; it also requires these facilities to provide community education on Advance Directives. All healthcare facilities are required to:

  • Provide information about health care decision-making rights.

  • Ask all patients if they have an advance directive.

  • Educate their staff and community about advance directives.

  • Not discriminate against patients based on an advance directive status.

In studying end of life decision-making, the Pew Research Center found that

  • 42 percent of Americans have had a friend or relative suffer from a terminal illness or coma in the last five years and for a majority of these people and 23 percent of the general public, the issue of withholding life sustaining treatment came up.

  • An overwhelming majority of the public supports laws that give patients the right to decide whether they want to be kept alive through medical treatment.

  • By more than eight-to-one, the public approves of laws that let terminally ill patients make decisions about whether to be kept alive through medical treatment.

  • One of the most striking changes between 1990 and 2005 is the growth in the number of people who say they have a living will - up 17 points, from 12 percent in 1990 to 29 percent now.

Another study found that between 65 and 76 percent of physicians whose patients had an advance directive were not aware that it existed. All the more reason for families to be involved in our decision making process.

For more information about advance care directives, log on to: www.clarian.org/portal/Education  click on "A" and go to "Advanced care directives."

Cyndi Alte serves on the pastoral care team of Clarian Health at Methodist Hospital in Indianapolis. She is a clergy member of the South Indiana Conference.