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The sickening spectacle of family members doing battle over a living corpse (not to mention the political opportunists who have latched on) should give us all pause.

The headline-grabbing cause of Terri Schiavo, the Florida woman who has been in a persistent vegetative state for 15 years, should have us all reaching for our pens and sitting down for a heart-to-heart chat with loved ones.

The best way -- no, the only way -- to avoid the acrimonious, heart-wrenching battles that have marked this case is to put your wishes in writing.

Prepare a living will, a simple document that allows you to specify when life-sustaining care should not be used. You can also designate a person to make health-care choices on your behalf if you are no longer able to do so.

Leaving directives, in the form of a living will or some other document, is an effective way of communicating your wishes to the health professionals caring for you. It is also a kindness to your family. It relieves them of the awful burden of having to divine your philosophical, ethical and religious values when making end-of-life decisions.

A living will should be an integral part of estate planning. Yet fewer than one in seven Canadians has a living will. The other six are inviting trouble should the unthinkable happen -- a stroke or an accident that leaves a person comatose, vegetative, or otherwise incapable of speaking for himself or herself.

(And while you're preparing a living will, take that pen and use it to sign your organ donor card. Far too many organs go to waste, leaving desperately ill patients in the lurch because someone didn't take 30 seconds to sign a driver's licence.)

When the paperwork is done, don't hide it where it won't be found until years after your death. Discuss your wishes with loved ones: spouse, children, whoever will make decisions on your behalf.

If you have a chronic illness, give someone you trust an enduring power-of-attorney. Make it clear what you want them to do, and not do.

In our modern society, we are far too squeamish about death. We studiously avoid discussing end-of-life care until a crisis occurs. That mistake has denied far too many people a good death and ripped too many families apart in the process.

About 230,000 Canadians die each year. A minority will die suddenly from traumas such a motor vehicle collisions and falls, and swift-killing infectious diseases such as influenza and pneumonia. The vast majority, more than 70 per cent, will succumb to a terminal illness such as cardiovascular disease, cancer, chronic obstructive pulmonary disorder, diabetes or Alzheimer's.

What that means, practically speaking, is that most people die slowly, and in a health-care setting. When a person has a terminal illness, many, many medical issues arise, and many tough decisions are required: pain management, tube feeding, resuscitation and ventilation. (For a no-nonsense discussion of these issues see Handbook for Mortals: Guidance For People Facing Serious Illness, a superb book by doctors Joanne Lynn and Joan Harrold.)

In the mythologized, sanitized view of death presented on TV and in movies, these treatments are provided routinely and seamlessly, and a person fades away ever so gently toward a final breath.

Reality is far more coarse and complex. At life's end, there is rarely a single condition to treat, but rather a confusing morass of overlapping conditions that can leave the patient confused, fearful and vulnerable.

Treatment can often be worse than non-treatment because of side effects. Terminally ill patients routinely refuse even the most basic interventions, as is their right. Even stopping food and water is commonplace: Patients have no desire to eat or drink, and there is no medical benefit in forcing sustenance on them. Some call these practices "backdoor euthanasia" but, in the final throes of death, they are humane and ethical practices.

You wouldn't know it from the fierce rhetoric that has emerged from the Schiavo case, but there is a compassionate, caring and largely effective system in place now for dealing with end-of-life decisions.

This system can be made even more effective if people make their wishes clear and explicit, in living wills and directives to loved ones.

In the final weeks, days, and hours of life, all efforts should be focused on palliative care, on pain relief, on saying goodbye -- in short, on ensuring a good death.

It should not be a time of second-guessing and bitter legal battles, but a time to truly respect a person's last wishes.

But for that to happen, the wishes must be expressed, clearly and unambiguously.

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