Williams: End of life ... and Hartsdale

It's easy to despise James Austin.

After all, the Hartsdale man, who was found guilty last week of second-degree manslaughter, did leave his 71-year-old mother, Ida Austin, dying on their living-room couch, her emaciated body lying half-naked in feces and urine.

James Austin didn't take his mother to a doctor or hospital as she became more sick and feeble. Prosecutors described the senior citizen as being a "bag of bones" when Austin finally called police to the house last July, after finding his mother unresponsive. Authorities found her body covered with maggots. Starvation, dehydration, infection and advanced bedsores caused her death.

Certainly, Austin appears to be a fine candidate for "World's Worst Son." He left his mother unattended at home while he went to work at the Westchester County Airport -- though he did give her something to battle the maggots: two cans of Raid. After the verdict was rendered following a two-week trial in state Supreme Court in White Plains, Westchester District Attorney Janet DiFiore said of Austin, "His total abdication of responsibility resulted in utterly abhorrent and deplorable conditions in the home and the ignominious death of his mother."

Despicable, yes. But there may be another point of view in this horrific story. In the defense testimony, Austin's attorney maintained that the son's failure to seek medical help for his mother was in line with her wishes, and that Ida Austin's belief in Santeria -- a religion with roots in Africa, with deities linked to the Roman Catholic saints -- caused her to eschew traditional medical care.

The problem is no one really knows for sure.

This an extreme case, to be sure. But death is a topic we all face, even though few want to think about, much less discuss, it. Yet as the country struggles to get health care costs under control, we will all need to confront the issue of end-of-life care head on.

If you want to ensure that when the time comes, your earthly exit truly goes just as you'd like it, create an advanced health directive or a living will. Guidance is available through several Internet sites, including the American Bar Association (www.americanbar.org), though to ensure that you're preparing a document that will hold up to legal challenge, you might want to have it reviewed by an attorney.

Documenting an end-of-life plan is a step too few have taken. A survey done last year by The Associated Press and the website LifeGoesStrong.com found that 70 percent of American adults -- and 64 percent of baby boomers -- don't have a health care proxy, living will or advanced directive.

These written instructions allow you to officially tell others how you'd like to be treated, or what medical actions to take, should you become unable to make your own health care decisions. Want to die on the couch without having any kind of medical intervention? Don't want to see a doctor ever again, no matter how sick you get? A living will ensures that no one is left to their own interpretations of what your wishes might be.

Failure to create one might mean that someone other than you -- and perhaps someone other than your favorite friend or relative -- ends up making decisions about your care.

Ida Austin's death is a tragedy on many levels. Creating your own guide to the end can be nothing but a help to you and those who love and care for you. If more people complete end-of-life directives, it could spare countless families from experiencing tragedies of their own.

Gayle T. Williams, a journalist for nearly 30 years, lives in Greenburgh. She's an editor at Consumer Reports. The opinions expressed here are her own.