Below is a contribution from Randi Siegel, NHDD State Liaison in Pennsylvania.

Nathan Kottkamp recently blogged here about the power of stories to motivate people to do advance care planning.  The Descendants, an award-winning film starring George Clooney, is one story that we can all use as a teaching tool.

First of all, just mentioning George Clooney may help get folks’ attention.  So, too, may the publicity around this movie (including Golden Globes for best picture, best actor Clooney, and an Oscar for best adapted screenplay).   

The film sets up Clooney as a middle-aged husband whose vital, healthy wife has just been seriously injured in a tragic boat racing accident.  She now lies in a coma on life support.  At her bedside, Clooney’s character, Matt King, pleads with his wife to awaken from her coma.  After three weeks of waiting, doctors tell the anguished King that she will never wake again.

Enter the living will.  Matt’s wife, Elizabeth, has completed one, and it states that she wants life support to be terminated in this type of medical situation.  (On a few sub-optimal notes, there is no mention of a health care power of attorney, nor any indication that Elizabeth talked with Matt about her wishes in addition to writing her advance directive.)  During multiple scenes, we see King telling family and friends of Elizabeth’s permanent condition and her medical wishes.   

The Descendants poignantly conveys the value of advance care planning for a family experiencing a devastating tragedy. 

For starters, by reminding viewers that anyone can be seriously injured in a sudden accident, it reinforces our message that advance care planning is for everyone, not just the elderly or the terminally ill.   

The movie also communicates the importance of advance care planning through what it doesn’t show us.  Precisely because Elizabeth has a living will, we don’t see the added emotional difficulties the family might face had she not completed an advance directive:

  •  We don’t see the doctor asking Matt King what he thinks his wife would have wanted, and King trying to decide, and potentially agonizing over, whether to terminate her life support.  
  •  We don’t see the compounded anger and resentments of Matt and Elizabeth’s rebellious teenage daughter (who, beneath it all, still identifies with her mother) that might result from seeing her father put in the position of making this difficult decision.  
  • We don’t see the added confusion of their 10 year-old daughter, who might perceive that her father has “chosen” to end her mother’s life.  
  • And while we do see Matt’s father-in-law blame Matt for his wife’s boating accident, we don’t see him blaming Matt for discontinuing the life support.  Without the advance directive document, Elizabeth’s grieving father might not be able to resist the temptation to blame Matt for this, too. 

When Matt King shows his wife’s father her living will and explains that she will be removed from life support, her father responds: “Elizabeth had the good sense to write this thing.  She’s a strong girl.  A thoughtful girl.”  

What we do see clearly presented on screen is that advance care planning is actually a gift to one’s family. 

Just as real stories can be a powerful motivator for advance care planning, so, too, can pieces of our popular culture.  We can use “The Descendants” story as another tool in our outreach toolbox, as we work to create a shared societal understanding of why advance care planning is important for all.