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Do your own planning <br> New York now has a new proxy law, but care decisions should be yours

Albany did New York families a great service last week when Gov. David A. Paterson signed the Family Health Care Decisions Act, a law that will enable a patient's family member to make health care decisions when the patient is not able to do so.

With the law, New York joins at least 35 other states and the District of Columbia is providing this authority to family members. Other states have case law supporting the practice. For too long, New York has been out of step, causing needless additional suffering for families that were already under extreme stress.

This broadly supported law will come into play when a patient is incapacitated and has not signed a health care proxy or left "clear and convincing" evidence of his wishes regarding medical treatment. The new law allows family members, including domestic partners, to make decisions regarding medical treatment. It includes safeguards to ensure appropriate treatment.

The risk of this law is that is will further disincentivize New Yorkers from having the frank conversations they need to have with family members regarding their wishes. That is the best way to ensure that patients get the treatments they want and, conversely, are not subject to procedures they do not want.

New Yorkers should have advance care directives to indicate their desires and to name a person to carry out those wishes. Useful documents include a health care proxy, a living will and a Medical Order for Life Sustaining Treatment, which is shared across health care settings, moving with the patient.

The subject of incapacitation and death can be hard to discuss, but one national expert on advance care planning, Dr. Patricia Bomba of Buffalo, says families can plan around that. Bomba, vice president and medical director for geriatrics at Univera Healthcare, has said her family has made a Thanksgiving tradition of attending to those chores, sharing information with family members gathered for the holiday. It's a proxy party.

The fallback is the bill Paterson signed on Tuesday. It's an important one, given that only 20 percent of patients have proxies. More should, but at least this law offers them and their families some better measure of protections.

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