Advance Care Planning: Collaboration
important to success and understanding
not easily located. (For example, one
patient’s directive states they do not want
CPR, but the healthcare provider missed
catching the direction until AFTER
CPR had been performed.)
• The agents didn’t sign the document.
• The directive is full of “legal-ease” and
refers back to previous paragraphs,
making it cumbersome to read and
understand.
• The directive is five to 20 years old and in
need of updating.
I have also worked with families whose loved
one completed a healthcare directive and the
families were well equipped to speak on the
person’s behalf when that time came, but this,
unfortunately, has not been the norm.
By Chaplain Sara Schwarz
“Do Great Things.” This was the title of the
State Bar Association of North Dakota’s
2019 Annual Meeting. As attorneys, you all
are in a position to “Do Great Things” for
all whom you serve. Whether your role is
in criminal law, family law, estate planning,
business law, or something else entirely, you
have been trained, equipped, and positioned
to have incredible influence in your
community. The people of our communities
turn to you for assistance and guidance in
some of their most challenging life situations.
In your role as attorneys, you all get a unique
glimpse into the lives of your clients.
It is my intention in this article to expand
the collegiality between law and medicine
in real, tangible, community-building ways.
To that end, I am going to focus on the
topic of estate planning and the creation of
healthcare directives. First, I thank you for
your dedication, diligence, and the hard work
you do as you serve our communities.
In my role as a hospital chaplain, I work
directly with families who have completed
a healthcare directive with their attorney.
When reviewing the directive, I have
discovered that:
• Some patients had not discussed their
directions with their own family or their
healthcare provider. (How can their
family/doctor/healthcare team follow
their directions if they are hidden in the
safe at home or tucked inside a file in
their attorney’s office?)
• Often the directions about whether
or not the patient wanted CPR were
buried in the depths of a paragraph and
New techniques have been developed over
the last 30 years for healthcare systems and
other professionals having advance care
planning conversations with clients and
patients. Research has demonstrated that
utilizing these conversations in the advance
care planning process over the lifetime of the
individual results in:
• Healthcare directives that are clearly
written and available to healthcare
providers.1
• Specific and easy-to-understand plans
are integrated into medical decision-
making.2
• Planning that is individualized and
person-centered in a consistent manner
across all settings.3
• Family members experiencing less stress,
anxiety, and depression when they out-
live their relatives. 4, 5
• Decreased decisional conflict.6
Chaplain Sara Schwarz is a Minnesota native who recently married one of your own and is eternally
grateful for the attorney who sat her parents down in the mid-1990s to help her dad create an Advance
Directive when he was diagnosed with terminal cancer. Rev. Schwarz completed her master of arts degree
in congregational and community care in faith and health settings at Luther Seminary in St. Paul, Minn., in
2009. In addition to 10 years of parish and community work, Rev. Schwarz has nearly 10 years of clinical
experience with the last two years as a chaplain at Sanford Health in Bismarck. She is a certified advance
care planning facilitator and instructor.
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THE GAVEL