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DON’T LEAVE HOME WITHOUT YOUR LIVING WILL

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If you are headed for Missouri - a layover in St. Louis, a weekend in Kansas City - let me suggest that you pack something extra in your baggage. A living will, for example.

Better yet, a signed and notarized durable power of attorney. Or perhaps a checklist of 30 life-sustaining treatments and your attitudes toward them.You might be wise to send copies of these to a lawyer and to a family member. And be sure to tell them that if you get sick or have an accident in Missouri, they'd better remove your body as quickly as possible.

This traveler's advisory comes to you courtesy of the Supreme Court. A week ago, the court ruled that people do have the right to stop medical treatment but only if they are conscious and competent or have left "clear and convincing evidence" of what they want. Otherwise, you may have no more rights than a museum exhibit, a comatose testimony to some state's definition of "life."

If you are like Nancy Cruzan, for example, 25 years old at the time of a car crash, you could end up in a permanent vegetative state for 10, 20, 30 years with no way out. If you are struck down without leaving behind a full record of your attitudes about the major bioethics questions of the day, you could become, as Justice William Brennan put it in his eloquent dissent, "a passive prisoner of medical technology."

This is the bottom line in the case of Joe and Joyce Cruzan's daughter. She has spent the seven unconscious years in a Missouri hospital being fed through a tube.

The court ruled that Nancy had not made her wishes known clearly enough. She had only talked about life and death the way most of us do, conversationally, casually. She "wouldn't want to live that way."

Without more certainty, the majority ruled that Missouri's right to protect "life" was greater than the family's right to defend her "liberty" from medical treatment. Chief Justice William Rehnquist said that there is "no automatic assurance that the view of close family members will necessarily be the same as the patient's."

In short, the state was more trustworthy than the family. Especially the state of Missouri, which has set itself on the extreme end of the pro-life spectrum.

This decision cannot help but raise the anxiety of Americans who have come to regard the end of life, the high-tech "twilight zone," with fear and loathing. For the overwhelming majority of Americans, some 70 percent to 80 percent, death comes after a series of decisions between patients, families and doctors about treatments to begin, try, end. For each American in a Cruzanlike condition, there are many more who are or will become incompetent before they die.

Once, in the '70s, families took a brain-dead child from one state to another that recognized this death. In the 1990s, we may have to shop again for a state that will allow patients and families to end treatment without a suitcase full of documents.