About 45% of adult Americans have prepared legal documents called "wills" that state how they wish their money and property distributed when they die. Some people have also prepared "living wills" that spell out what medical steps, if any, may be taken to prolong their lives should they be unable to communicate. A hospice in the Midwest state of Iowa teaches its dying patients about a third kind of will that's much more philosophical and emotional.
It's called an "ethical will." The idea traces to the first book of the Jewish and Christian bibles, in which the dying Jacob gives his children what in Hebrew is called his tzava'ah, or "spiritual estate." Passing along the wisdom, advice, and blessings of elders is a familiar tradition in Native American and other cultures as well.
At the Hospice of Central Iowa in West Des Moines, staff member Joel Fry helps patients prepare ethical -- or what some call "heritage" or "legacy" -- wills. He explains, "What are some of the life lessons that we have learned over the course of our lives . . . based on those important times that we identify in our lives that were life-changing events? Maybe birth of children, maybe marriage, maybe deaths. And then what did those times teach us, and how did they all stack together into who we are today?"
Mr. Fry says most people have a desire to leave behind something more meaningful than material goods. "It may be those opportunities to share where it is we came from, what we're about, why we chose decisions that we chose or made decisions that we made throughout our lives. It's an opportunity to deal with regret and forgiveness."
Mr. Fry works with materials developed by Bruce Baines, a Minnesota family physician, whose website, www.ethicalwill.com, includes examples of ethical wills, such as these thoughts of a 64-year-old widow:
"To you who are reading my Heritage Will: Please know how important you are to me and how much I love you. Maybe God should have arranged it so that we'd be 'older' first -- then younger -- so we could've used all that wisdom along the way . . ."
Roberta, or "Bert" Goodman, as she is known, is a former nurse who volunteers at the Hospice of Central Iowa. Though an ethical will has no monetary value, she calls it priceless. Ms. Goodman says she jots down thoughts as they come to her -- on scraps of paper, in notes to her children, even in the margins of telephone books. She's saving them all in what are called "memory boxes." "I was raised with the belief that every time I left the house, I represented my family," she says. "I represented my church. And I represented my country. Things such as that. Things such as honesty, integrity, not lying, not cheating -- standing up for what you believe."
Bert Goodman says she hopes her notes will help her children think about their own life options . . . "their own values, put a name to them, and discuss them with their own families -- and also honor my wishes" . . . including her wish to die at home if possible, rather than in a hospital, when the time comes.
Gary Burkhart, a nurse at the Hospice of Central Iowa, is a former minister. He, too, is writing an ethical will in the form of letters to his children. "I try to encourage them and tell them how proud I am of them," he says, "rather than waiting until the end, when I may not be able to do that. I want my kids to know who I am and what I do think. "
Mr. Burkhart says the exercise has been therapeutic: "It has helped me tremendously and has given me satisfaction knowing that I have been able to express myself to my kids and my family, my parents, about how I feel and where I'm at."
Joel Fry at the Hospice of Central Iowa points out that one does not have to be an accomplished writer to compile an ethical will. It can start with a simple timeline, or a list. "Just number 1 through 30, the most important things in your life," he says. "There are individuals who'll sit in front of a movie camera. Many times I've had a movie camera going, and that's how they choose to do it."
The hospice workers say one of their saddest experiences is watching patients rage against the steady loss of independence -- their homes, the freedom to drive, even their memories. All the more reason, say the staff members, that recording thoughts about life's lessons and blessings should not be a matter left till one's deathbed.