Most people don't want to think about death, much less plan for it — especially when they feel healthy and young in their middle-age years. And that, some U.S. baby boomers say, is one of the big reasons so few of them have end-of-life legal documents such as a living will.

大多數人不願思考死亡問題，遑論規畫身後事宜，自覺健康年輕的中壯年一代尤其如此。針對這點，美國部分嬰兒潮世代解釋，這正是他們很少預立生前醫囑這種臨終法律文件的主因之一。

An Associated Press-LifeGoesStrong.com poll found that 64 percent of boomers — those born between 1946 and 1964 — say they don't have a health care proxy or living will. Those documents would guide medical decisions should a patient be unable to communicate with doctors.

美聯社─堅強生活網的民調發現，1946至1964年間出生的嬰兒潮世代，有64％表示未設醫療代理人或生前預囑。當終末病人無法和醫師溝通時，這些法律文件可做為醫療決策指南。

“I'm very healthy for my age,” said Mary McGee, 53. “So, death and dying isn't on my mind a lot.” McGee, a computer programmer, exercises five to seven days a week, everything from aerobics to kickboxing, and her parents are alive and healthy.

53歲的瑪麗．麥吉說：「以我的年紀而言，我算很健康的，所以不常想到死亡和臨終事宜。」麥吉是電腦工程師，每星期健身5到7天，從有氧舞蹈到自由搏擊無所不包，而且父母都還健在。

The same goes for 57-year-old Sandy Morgan. “You know when they say, 'Sixty is the new 40,' I really believe that,” said Morgan, a retired teacher who is working part time for an executive search firm. Morgan's parents are still healthy in their early 80s. She says she runs twice a week, practices yoga twice a week and takes part in a rigorous fitness boot camp twice a week. End-of-life decisions aren't on her radar.

這同樣適用於57歲的珊蒂．摩根。她說：當人家說「60歲是『新40歲』」時，她深信不疑。她是退休教師，目前在一家獵人頭公司兼職。摩根的父母80歲出頭，身體仍很健康。她說，她每周慢跑兩次，做瑜伽兩次，另外參加嚴格健身訓練營兩次（見圖／美聯社）。臨終醫療代理人問題對她而言並不存在。

A living will spells out a patient's wishes for medical care if he or she is unable to communicate with doctors. The health care proxy, also known as a health care power of attorney, allows an individual to select a person he or she trusts to make decisions about medical care should the patient become incapacitated.

當醫生與病患無法作溝通時，生前醫囑清楚載明病患的醫療意願。醫療代理人，又稱醫護委託授權人，允許個人選擇他或她所信任的人選，在病人失能時，代為做醫療決策。

Kathy Brandt said living wills and health care proxies are a good idea for everyone whether they are healthy and young or older and not so healthy. Brandt, a senior vice president at the National Hospice and Palliative Care Organization, said the two documents can spare families a painful fight and ensure that patients receive — or don't receive — the medical treatment they wish should they end up in a situation where they can't speak for themselves.

凱西．布蘭特說，生前預囑及醫療代理人對所有人都是有備無患的好構想，不管他們健康年輕或年長身體又欠安。布蘭特是「美國國家安寧緩和療護組織」資深副總裁，她說，這兩項文件可減少家庭的痛苦抗爭，並確保病患在無法說出自己意願時，可表明願意或拒絕接受的醫療措施。

The living will is not “all or nothing,” said Brandt. A person could say he or she wants everything, something or nothing. For example, one person may want heroic measures taken to prolong life, while another may want to be resuscitated but decide against being dependent on breathing machines long-term.

布蘭特說，生前預囑並非「全要或全不要」，一個人可以說他或她想要所有的醫療照護，或只要部分，甚或完全不要。例如，他可能願意勇敢接受延長生命的種種醫療措施，另一個則可能只要做心肺復甦術，但決定不要長期依賴呼吸器。

Brandt pointed to high-profile cases such as the Florida family fight over Terri Schiavo as a smart reason to draft a living will and health care proxy.

布蘭特舉佛羅里達州泰莉‧夏沃家人互相抗告這個眾所矚目的個案為例指出，預立生前預囑及醫療代理人是明智的做法。

At 26, Schiavo collapsed at her home in 1990 with no end-of-life care instructions in writing. Her heart stopped and she suffered what doctors said was irreversible brain damage that left her in a permanent vegetative state. Her husband said his wife would not have wanted to live in a vegetative state; her parents wanted her kept alive.

26歲的夏沃1990年在家中昏倒，但未白紙黑字寫下終末醫護指示。她因心跳停止，醫師宣判腦部遭到永久性損傷，永遠成為植物人。她丈夫表示，妻子不會希望以植物人狀態活下去；但她父母希望讓她活著。

What ensued was a yearslong legal battle that involved dozens of judges in numerous jurisdictions, including the U.S. Supreme Court, and Congress. Schiavo's feeding tube was ordered removed in 2005. About two weeks later, she died.

隨之而來的是長達數年的互打官司，其中涉及無數司法主管機關，包括美國最高法院和國會數十位法官。2005年夏沃的進食管被勒令移除，大約2星期後去世。

Each state has its own forms for proxies and living wills, said Brandt. “And while it's a legal document,” she said, “you don't need an attorney to draft one. The forms need to be witnessed, but that's it.”

布蘭特說，每個州各有不同形式的醫療代理人和生前醫囑。她說，雖然這是法律文件，「你不需要請律師草擬文件，但需要有人在場見證，僅此而已。」

To get motivated, we often need to witness a crisis. “Somebody has a family member who gets sick, or there's a fall, there's an accident, where all of a sudden people realize, 'I haven't thought about this,'” says family-care consultant Melissa Kahn, head of Kahn HealthCare Consulting in Chicago.

我們往往要親眼目睹一場危機才會起而行。芝加哥卡恩醫療衛生諮詢公司負責人、家庭照護顧問梅莉莎．卡恩說：「某人的家人生病，或跌倒，或發生意外事故，這時所有人突然認清，『我從沒想過這件事。』」

Consider hiring an outside mediator who can make it easier to bring up uncomfortable issues. “We don't like to talk about the what-if's and end of life,” says Kahn. She sends her clients a document that summarizes what they have agreed on – and encourages them to revisit the issues in a year or two, since feelings may change. “Living wills are not irrevocable,” she says. “Life is a process.”

可以考慮聘請外部協調人員，當令人不舒服的問題出現時，他們可以幫上忙。卡恩說：「我們不喜歡談萬一有個三長兩短之類的問題。」通常她把文件送給客戶時，上面會總結他們的同意事項，並鼓勵他們每隔一兩年重新檢視一遍，因為想法可能會改變。她說，「生前預囑並非不可反悔推翻的，畢竟生命是個過程。」