01 May DETERMINE WHICH ADVANCE DIRECTIVES WOULD BE BEST FOR RUTH.
Hypothetical: Ruth Zia is an intelligent 76-year-old woman in good health. Ruth is a widow and would like to designate her daughter, Miranda Mboya, to handle her medical and financial affairs in the event of disability. Ruth trusts Miranda totally. She also trusts her other child, Janna Andrusz, age 43, but feels that Janna might not be as emotionally able to handle the responsibility, particularly decisions that would concern Jannas own child, Bryant. Bryant is an irresponsible alcoholic and Ruth does not want any of her money used to enable his behavior. She has written a will that addresses the situation. Ruth is wealthy enough to worry about estate taxes, so she has had the habit of giving each of her daughters $10,000 as a gift each year, but has given Janna her gift by paying $10,000 toward Jannas mortgage, to prevent Janna from giving Bryant cash. An issue of concern to Ruth is that Miranda works for an international charity and spends about half of her time in Africa; she has a home there and is married to a citizen of the country in which she has a home. Miranda is 49 years old has no children. Ruth has only one other close relative, her brother, Mathew. Mat is 81 and in poor physical health, but mentally alert. Ruth would trust Mat to make her financial decisions, but she would not want either Mat or Janna to make health decisions. She feels that they are “soft-hearted” and would try to prolong her life at all costs. Ruth is adamant that she would not want artificial nutrition or hydration and does not want to be kept alive in a vegetative state. Unless she has a reasonable chance of recovery to a good quality of life, Ruth wants medical care to be limited to pain control.
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