Without information and conversations about what to do, and to what lengths to go, in various end-of-life medical situations, a person can give up choice and control of their life. Some individuals want no heroic actions taken. Others want doctors and nurses to do everything possible to keep them alive for as long as possible. Knowing the rules and the options before hand can make that time at the end of life less stressful for the person dying and their family and friends. And it can make sure the patient's wishes are carried out.

The present debate about health care reform aside, allowing for end-of-life counseling makes sense. It should not be mandatory. The individual's choice, or lack of choice, needs to be honored.

For some people, it's important to have all options laid out before them when a critical medical decision must be made in a life-threatening situation. To have previously gone over the ground in a counseling session gives that person a better foundation from which to make a decision. It means less information that must be processed in a crisis.

If for some reason that person is unable to decide, because they are not conscious or coherent, then having a document indicating what lengths the medical team should go has value. It can take the burden of making enormous pesonal decision off family members.

In North Dakota law, there's provision for a health care directive or living will. Interesting the law reads: "Every competent adult has the right and responsibility to make the decisions relating to the adult's own health care, including the decision to have health care provided, withheld or withdrawn." No, it can't be scrawled on the back of an envelope. It must be signed by the person and that signature must be verified by a notary public or at least two witnesses. It can give specific directions or name a power of attorney. But as long as a person can make decisions and communicate them, the document does not go into effect.

Couple the requirements of the North Dakota law with some honest end-of-life counseling and people facing a health care crisis are much better prepared.

Congress should not dither on this issue. It should enable it with clear language and should maintain the patient-physician relationship as free from government oversight as possible.

Knowledge and information are critical for people at all stages of their lives.