The one estate planning document that everyone 18 and older should have is an advance health care directive.

Karen Ann Quinlan and Nancy Cruzan were young women whose legacies are legal battles over medical care for individuals who cannot speak for themselves.

Karen’s case determined that “medical treatment” includes life-sustaining measures, and that those measures can be declined by a patient or someone acting on the patient’s behalf.

Nancy’s case was a battle between Nancy’s family, who believed that Nancy would not want to be sustained on a tube, and the State of Missouri, which asserted that only the patient can make that decision. Nancy’s family convinced the court that Nancy did not want to be kept alive artificially, and food and water were withdrawn.

The bottom line?

We have a right to say “enough is enough” when it comes to medical care, including the use of respirators and tube feeding. We also have the right to name who will speak for us when we cannot speak for ourselves. Having a clear and comprehensive advance health care directive is only way to be sure that your wishes will be known and carried out.


SCOTT MAKUAKANE, Counselor at Law
Focusing exclusively on estate planning and trust law.
808-587-8227  |