by Julia C. Reischel

In the wake of Terri Schiavo’s famous end-of-life legal battle, which ended with her death in April, a Somerville law firm has noticed a sharp increase in requests for “living wills” from Somerville residents.

“There’s been a big response to the Schiavo case,” said Charles J. Sillari, Jr., who specializes in family law and domestic relations for Sillari and Glines Attorneys at Law. “It heightened everyone’s awareness.”

“Some of our clients have called have called us randomly asking about ‘living wills,’” said Stephen A. Glines, Jr., the firm’s other partner.  “They’ll call it a ‘living will,’ which doesn’t even exist in Massachusetts.  That didn’t used to happen often.”

“There’s been a significant spike in requests,” Sillari said. 

Terri Schiavo died in Florida after state legislators, multiple judges, and the US Congress were drawn into an unprecedented legal struggle over whether she had a right to remain on life support against the wishes of her legal guardian. 

Schiavo, who had been in a “persistent vegetative state” for over a decade, had not left a living will dictating her wishes in the event of such a situation.         

Sillari and Glines said that while Schiavo’s predicament has raised awareness about the need to have a “living will,” Massachusetts residents cannot use living wills to avoid a difficult end-of-life situation like Schiavo’s. 

“Massachusetts does not recognize living wills,” Glines said.  “Instead, the state recognizes health care proxies, which are different from living wills.”

A “living will,” as defined by Black’s Law Dictionary, is “a document which governs the withholding or withdrawal of life-sustaining treatment from an individual in the event of an incident of irreversible condition that will cause death in a relatively short time.”   

“A health care proxy, which Massachusetts does recognize, accomplishes the same things as a living will,” Sillari said. “It appoints a person to make your health decisions for you.”

According to the General Laws of Massachusetts, a “health care proxy” is a document an individual can use to delegate the authority to make health care decisions to an “agent,” another person. The mechanism is designed to give the agent authority to make “any and all health care decisions” for a person in the event that the person “lacks the capacity to make health care decisions.” 

“The difference is that a living will is a document, while a health care proxy designates a person—an agent—to make those decisions,” Sillari said.

Silliari said that a health care proxy is the only legally recognized mechanism in Massachusetts for a person to express his wishes for end-of-life medical care.  “They’ve never recognized living wills here,” he said.

Both Sillari and Glines said that they think health care proxies are just as effective as living wills at safeguarding the medical wishes of an individual, and that they are more flexible in the long term.       

“I feel as though a health care proxy, explained the right way, is better than a living will,” Sillari said.  “Living wills are specific in nature, and you can’t know all the options ahead of time.  Medical technology can change, and unforeseen circumstances can arise.” 

“I think that a health care proxy achieves the same thing as a living will,” Glines said.  “With a proxy, you can still express your wishes and set guidelines for the decisions the agent makes. It can be used as evidence of what your wishes and desires are.”

The attorneys said that they encourage their clients to go beyond the letter of the law when appointing health care proxies. 

“By statute, the agent doesn’t have to know that he has been appointed someone’s health care proxy,” Glines said. “But that’s a big responsibility.  We try to be proactive so that a situation like Schiavo’s doesn’t happen.” 

The Sillari and Glines health care proxy form includes a line for the agent designated to sign, which is not a standard practice at most law firms, Glines said. 

“This encourages the agent to have a conversation with the person whose decisions he will be making,” he said.  “We are always proactive, trying to get the agent involved.”

“You want to have an agent with the same beliefs as you, and you want someone who is comfortable doing it” Sillari said, “You should sit down with your agent.  He or she should be someone you trust.”

When Sillari prepares a health care proxy for a client, he said he follows a set protocol designed to make them think about various situations they could someday face. 

“You can several different ways,” he said.  “You can take a minimal approach and just designate an agent, or you can be more specific and describe specific situations.  I like to sit down with the person and ask him how he feels about these things.” 

Sillari and Glines Attorneys at Law was started four years ago and is most famous for its participation in a high-profile case involving the first dissolution of the civil union of a gay couple in Massachusetts, Sillari said.  Because the case happened before Massachusetts legalized gay marriage, he said, it involved a Vermont civil union and was one of the first cases of its kind in the country. 

“We were the first law firm in Massachusetts to do a dissolution of a civil union,” said Sillari. “It was a long-running case that took over a year to get resolved.  We got a ton of calls from law schools and other attorneys.” 

Despite their brush with fame, Glines said that they are first and foremost a local firm. 

“We’re just the local Somerville guys.  We like to be a part of the community,” he said. 

Glines said that he was originally from Somerville and still has parents and grandparent who live in the community.  Sillari lives on Henry Ave. and grew up in the area as well. 

Sillari and Glines said that it’s important for everyone to have a health care proxy. 

“A lot of people come in to get a will when they’re planning a vacation,” Sillari said. “Around the holidays, too.”

“As if you can’t die suddenly in Davis Square,” Glines said.  “Writing a will and designating a health care proxy eliminates all the uncertainty,” he said. 

“Everyone should have a health care proxy,” Sillari said.  “Do you?”