Stepping into one of the most controversial issues of our time, a California hospital is considering a new policy that would allow doctors to deny aggressive treatment to patients whose cases they consider hopeless.

According to a recent article in the San Jose Mercury News, the policy under discussion at El Camino Hospital in Mountain View, Calif., is a radical proposal in an era when doctors often feel compelled to provide almost any treatment available.Now the pendulum is swinging the other way. Doctors are under extreme pressure from health maintenance organizations to reduce costs by undertaking fewer procedures. Even the experts are uncertain when treatment becomes futile, and it is not inconceivable that at some future date doctors and HMOs will require elderly patients to exist at a higher level of performance, perhaps dooming patients with advanced Alzheimer's disease, for example.

"Skeptics worry that such policies come dangerously close to promoting euthanasia and could be abused in today's managed care environment," warned the story in the Mercury News. Or as Ernie Young, head of Stanford Medical Center's biomedical ethics committee, put it, "Futility is very much in the eye of the beholder."

This development makes estate planning more important than ever. By establishing an effective estate plan, you can ensure that you have a voice in decisions affecting your life and death and can even help toward making sure you have access to long-term health care in your retirement years.

For instance, you can create a Durable Power of Attorney for Health Care, which authorizes someone you choose to make health-care decisions for you should you become incapacitated. Similarly, should you become incapacitated, a Durable Property Power of Attorney authorizes someone you choose to manage your property (i.e., property not otherwise controlled by a trust).

These are valuable components to a solid estate plan, providing guidance and certainty when your family members may be most vul-nerable to the influence of others.

Advanced estate planning can even improve the quality of your retirement years by planning for long-term health care so that you do not have to draw down all of your assets to qualify for public or private health care assistance programs.

Those who fail to plan their estates run the considerable risk of exposing their families to a "living probate," technically known as a guardianship proceeding or conservatorship. If you become mentally disabled before you die, the probate court will appoint someone to take control of your assets and personal affairs. These court-appointed agents must file accountings with the court, and the entire procedure can be expensive, time-consuming and humiliating.

In today's "Brave New World," what constitutes acceptable treatment of the elderly is changing and will continue to change as events and trends dictate. That's why it's important to create an estate plan that protects your interests while you're alive and protects your family after you're gone.

By the way, if you are an Internet user, take a look at the following web site which provides comprehensive information about long term health care: ( While you're at it, take a look at our law firm's web site (see below) which contains numerous links to other Internet sites containing information about issues facing our aging population.