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Rochester Medical Students Simplify Creating Health Care Proxy

Tuesday, November 15, 2005

Two University of Rochester School of Medicine and Dentistry students have developed a Web site that makes doing the paperwork of health care proxies and living wills quick and easy.

The Web site at offers free tools to create, print and save the forms required to designate a health care agent and to list specific health care wishes for a time when illness or injury prevents communication.

“Thinking about these issues is difficult and it should be difficult,” said Anne Fugle, a fourth-year medical student who initiated the proxy project. “But once you’ve made those tough decisions, filling out the forms should be straightforward and not complicated.”

While doing her neurology rotation at the University of Rochester Medical Center, the need for health care proxies and living wills became clear to Fugle. She also was affected by the legal struggle over Terri Schiavo.

“Neurology is one of several rotations where it is more stark, where we see patients who are unresponsive from stroke or other conditions but who have not made their wishes clear,” said Fugle, who plans to become a psychiatrist.

Making the material available online in a simple manner and without charge should prompt more people to create proxies and living wills, Fugle said.

“If it had been online, I’d have mine done,” she said.

A visitor to the Web site fills in boxes and answers questions to complete the forms in an easy process that takes several minutes. The Web site initially was aimed at New York residents. But it now generates forms that meet the requirements of 35 states. The site also provides links to other sites that provide helpful decision-making information.

Fugle created the first version of the Web site. Another fourth-year medical student, A. Brock Roller, expanded and enhanced the site. Fugle and Roller developed the Web site to meet a Rochester School of Medicine requirement that all fourth-year students participate in a project that benefits community health. At least two other medical students will take on promoting the Web site.

In the first two months of operation, more than 850 individuals visited the Web site, making more than 20,000 hits. Some have filled out surveys after using the Web site. Roller said the response is encouraging and the feedback has led to changes in the Web site.

“We don’t know how many people made proxies and wills but if one or two did who would not have, I’m happy,” Fugle said.

Timothy Quill, M.D., director of the Center for Palliative Care and Clinical Ethics at the University of Rochester Medical Center and well-known expert on end-of-life care, recommends the Web site.

“Despite the tragic case of Terri Schiavo educating us about the consequences of not having an advance directive, we still know that four out of five Americans are avoiding the final step of completing a document,” Quill said. “These University of Rochester medical students have made a terrific effort to close that gap by making it easier to complete an advance directive online, print it, and send it to your family and physician.  The site is easy to access, prompts the user to make key decisions, and then generates a clear document which when witnessed meets all the legal requirements.  Try out the site, and send the link to those you care most about.”

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