In the past, we’ve discussed the highly controversial and ethically debated issues of doctor assisted suicide and right to die by refusing to take food and water in your waning days. At the heart of these debates are a person’s religious views and how much suffering someone must endure in the event of a terminal illness or other physical condition.

These are different than having a DNR – do not resuscitate – order.

The issue of what do in the waning days of one’s life re-ignited last week with the death of former First Lady Barbara Bush.

The 92-year-old wife of former President George H. W. Bush and mother of former President George W. Bush and former Florida Governor Jeb Bush had been suffering from congestive heart failure and chronic obstructive pulmonary disease (COPD) for a number of years. It was obvious to her and her family that she was nearing the end of her life.

She was at her home in Houston when she let her family know that she didn’t want any more medical treatment to fight her illnesses. All she wanted was ‘comfort care’ which would just keep her from a lot of pain and suffering as she eased towards death. She told the family that she had decided:

“…not to seek additional medical treatment and will focus on comfort care.”

She had described her self as being on a conveyor belt of expensive medical treatments, none of which could cure her condition, only prolong her life, which was something she no longer wanted to do.

Dr. Joanne Lynn, Director of the Program to Improve Elder Care at Altarum Institute, commented on Bush’s decision:

“It makes perfectly good sense at her age, with her failing health, that she would say at some point, ‘Life’s been good, and while you always want more, it’s enough’.”

The Conversation Project urges families to not only talk about their end-of-life wishes but to document them. Ellen Goodman, Co-Founder of Conservation Project, commented about Bush, saying:

“It sounds like this forthright, outspoken woman has made her wishes known and the family is standing by her.”

Nathan Kottkamp, Founder and Chair of National Healthcare Decisions Day also commented on the subject:

“It’s a personal decision that she didn’t have to share, but hopefully it will encourage others to think about their choices, talk about their choices, document their choices and have those choices honored.”

My wife and I recently met with an attorney who helped us with some of these important issues and my wife and I have discussed these issues in length and know how each other feels. We also involved our oldest daughter in the discussion. She is 41 and since my wife and I are both in our mid-60s, we wanted her to be aware of everything and witness the legal documents we signed at the attorney’s office.

I highly recommend that everyone, especially those over the age of 50 sit down with your spouses, kids or whoever is closest to you. Be honest and make sure they know what your wishes are if you are not able to make those decisions or to prevent them from going against your wishes. Spend the money necessary to have it in writing with an attorney to make it legal. If you have specific wishes, then, this is how to make sure those wishes are followed.