Question. My husband and I are retired and have three children, all of whom are married and have children of their own. By our choice, we never discussed anything with our kids about our wills because we feel that matters like that are private and should be between my husband and me (not that it will be a surprise to our children that each of them will get an equal share).

We signed our wills in the mid-1980’s, and, thank the Lord, nothing terrible has happened in our lives that would ever make us want to see the inside of a lawyer’s office again. However, shortly after the Terri Schiavo fiasco that we followed on television, our children began asking us if we had signed “living wills” so that our intentions would be in writing and there would be no family disputes.

At first we were taken aback, but after discussing it, my husband and I decided that, like our wills, everything should be kept between him and me until we die. Our parents never discussed these kinds of things with us, and everything worked out. We can see no reason to discuss these private things with our children. Are we missing something?

Answer: Absolutely. Although the world is a much more complex place than it was 20 or 30 years ago, most folks – like you and your husband -- are still more concerned about their assets and the management of their assets than how their health care decisions will be handled should they be unable to express their preferences.

Only after a family crisis impacts them directly or they have taken the time to allow a professional to point out the many complicated issues in the health care control area, do most people become aware of the significant number of soul-searching issues that should be addressed.

In planning for health care decision-making, there are usually three areas of concern that must be dealt with: (1) Life vs. Death. Under what circumstances, if at all, should medical treatment, artificial nutrition, and hydration be withdrawn to allow us to die a natural death? (2) Continuation of Life. What medical treatment should be provided – or not provided – where medical decisions do not involve Life v. Death issues?, and (3) To whom should medical personnel turn for guidance in making these decisions for us if we are incapacitated or otherwise unable to express our treatment preferences?

Tangential to these three major areas -- and often the source of bitterness among families – are such other important issues as enforcing our rights under the Patients’ Bill of Rights and burial or other disposition of our earthly remains after death.

While each state has enacted laws allowing us to sign documents to allow others to make and enforce our medical decisions, the laws, unfortunately, have not kept up with medical technology or the issues that face American families today.

Because of the breadth and importance of these topics, and because of our space limitations, we will devote the next several columns to controlling your health care decision-making when you are unable to express your wishes.

First, to dispel some of the myths. 1) A “Living Will” has become a generic term that is, unfortunately, used improperly to describe all health care-planning documents. In reality, “living wills” are documents created by state law through which individuals can express in writing their wishes about the refusal or withdrawal of life-sustaining treatment when in an end-of-life situation. For a living will to become effective, the signer must be unable to express his or her desires and must be either terminally ill (in layman’s terms, is expected to die within a reasonably short period of time) or persistently vegetative (in layman’s terms, has no brain function). The generic word for health care decision- making documents should be “Advance Health Care Directive” or “Advance Directive,” of which the living will is but one type of document. 2) If you sign an advance directive, you retain the ability to make your own decisions unless or until you are no longer able to express your preferences. In other words, just because you appoint someone to make these decisions for you doesn’t mean they have immediate control. Next week more on how to control your own health care decision making.