Dear Cyndy,

Thank you for your letter. What you need to keep in mind
about living wills and powers of attorney for health care is:

a) in Ohio, both these documents are subject to absurd,
and to some extent perverse regulation.

b) to be effective both documents require formal execution.
They must be withnessed and notarized.

c) discretion regarding the power of attorney for health care
extends to nominating the attorney-in-fact. You have selected
Victoria. That's o.k.  You should also select two or more
"alternates" to act if Victoria for one reason or other was
not immediately available.

d) the living will constitutes your directives to the physicians
who might be treating you during a period of time when you were
physically or mentally incompetent: i.e. unconscious, demented,
aphasic. My suggestion (for myself) is a statement such as:

"I hereby direct that if I am unconscious or demented
or if for any other reason I am unable to express
my wish and my determination,
unless there is a substantial probability
that on recovery I should be able to lead
an intelligent, productive and comfortable existence,
no diagnostic or therapeutic measures shall be taken to prolong my life,
including, not to the exlusion of others,
no intubation no mechanical ventilation,
no tube or intravenous feeding,
no administration of antibiotics,
no cardiac or pulmonary resuscitation."

A legal, social, psychological, and if you will
ethical issue is created by the phrase:

"unless there is a substantial probability
that on recovery I should be able to lead
an intelligent, productive and comfortable existence,"

because the absence of "a substantial probability
that on recovery I should be able to lead
an intelligent, productive and comfortable existence,"

is not a conventional definition of "terminal illness".
(It's rather a reflection of my own longing for death.)
Many, if not most, individuals would want to "hang in there"
even if on recovery they were unable "to lead
an intelligent, productive and comfortable existence,"
This issue, the description of the circumstances under
which you would not wish to be kept alive, is a matter
for you to meditate on and to decide.

Even so, the physicians and hospitals would probably resist
a living will that expressed what they deemed an unduly
pessimistic, quasi-suicidal intent. That's why, if you really
want to be safe from Big Brother, you will avoid institutionalization,
(hospital, nursing home, retirement community, doctor's office)
if at all possible.

If you need copies of the living will or health care power of attorney
that I attached to previous e-mails, or if you have further questions,
just ask.

==========================

I did attend yesterday's concert as well as about 12 hours of
rehearsal, and I'll go again today. The concert yesterday was
stunningly successful. The hall was crowded. I was the embarrassed
target of many congratulations."mazel tov" is something I can do
without. What was so moving to me was to be a witness to the
fulfillment as it were of my own lifelong frustrated, disappointed 
love of music, to observe this grandchild of mine, whose facial
expressions, even the incipient ptosis of the right lower eyelid,
are often reminiscent of what I see in the mirror, able to make
real the substance of my disappointed dreams.

In a few minutes, I'll drive to the airport to fetch Klemens
who hopes to get to this afternoon's performance. Meanwhile
my best to you and Ned.

Jochen