Americans urged to sign living wills.

Most people do not know they have the right to request or refuse medical treatment should they become incapacitated. But if one organization has its way, a million U.S. citizens will sign living wills this year alone.

Choice in Dying, a New York-based nonprofit advocacy group for patients' rights at the end of fife, unveiled a public education campaign on advance directives in November. There are two types. In a living will, a person specifics wishes about medical treatment should that person be unable to communicate. In a durable power of attorney for health care, someone can designate another son to make decisions about medical care should the signer not be able to speak for himself or herself.

"Our goal in this campaign is to make sure that Americans know how to exercise their legal rights in end-of-life decisions and make their rights a reality," said Dr. Karen Orloff Kaplan, executive director of Choice in Dying. At a Washington, D.C., press conference announcing the campaign, Kaplan cited a 1991 Gallup poll showing that 75 percent of respondents approved of living wills; of those, 20 percent actually had signed one.

Choice in Dying is planning to reach out to consumers, health care providers, elected officials, and other opinion makers through its campaign, "Choose ... Or Someone Else Will." It has already established a toll-free line (800-989-WILL) staffed by trained professionals who can provide personal advice, legal assistance, free advance directive documents, and die latest information on state regulations. The group has also established a network of state lawmakers who are responsible for passage of advance-directive legislation.

The group is urging that advance directives be incorporated into the proposed national health care reform. It recommends that "advance directives" be established as a check-off item on the proposed National Health Security Card and that all doctors discuss possible end-of-fife medical choices and preferences with their patients while they are taking standard medical histories.

During the Washington press conference, Christy Cruzan White - whose sister, Nancy, was kept alive by feeding tubes for seven years - said one of the greatest gifts a person can give loved ones would be to take responsibility by preparing an advance directive. The Cruzan family fought a long legal battle to stop the tube feeding that kept Nancy alive while she lay in a persistent vegetative state following a car accident. The tube feeding was stopped on December 14, 1990. Cruzan died 12 days later.

"Young people can be the most vulnerable to being held hostage to medical technology, simply because their wishes are not known," cautioned White, whose sister was 25 at the time of the accident.