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The Terri Schiavo case is perhaps the most well-known example of what can happen when severely incapacitated patients can’t express their treatment wishes, and haven’t signed an advance health-care directive. Now researchers say the very medium that brought us memorable images of Schiavo could be used to make patients’ intentions more clear.

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University of Florida researchers say written advance directives are sometimes ignored by doctors and argued over by family members. But a video version, a five- to ten-minute tape of the patient sharing his or her treatment wishes while still of sound mind, may clear up some confusion. And experts say hospital physicians are often caring for incapacitated patients they’ve never met before and are therefore sometimes reluctant to withhold treatment.

Dr. Ray Moseley / UF medical ethicist

“It’s more likely that a patient will have very strong views about end-of-life care, not want very aggressive treatment, but yet they will receive it precisely because the family disagrees, or the physician’s uncomfortable or they can’t find the legal document and the patient’s wishes simply would not be honored.”

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U-F researchers don’t think the written form of advance directives should be scrapped. Instead, they see video as a supplement. Some states require an advance directive be signed in order to be legally binding. In Florida and some other states, an advance directive also must be witnessed to be legal. But the video could help clear up confusion, particularly for family members.

Dr. Ray Moseley / UF medical ethicist

“When you have conflicts among family members that ‘Oh, mom really didn’t want this… or grandma wouldn’t want this kind of... she would want everything, or wouldn’t want everything’ you can show them the video of grandma saying what she would want and not want, and we believe that will lessen family conflict.”

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At the University of Florida Health Science Center, I’m Mike Garrison