Online resource center to help you explore these key issues, and others, regarding your estate.

Practice Areas

Mr. Miller has many years of experience in designing and implementing a comprehensive variety of Trusts, Wills, and other estate planning documents, as well as settling estates in the most expedient and appropriate method. Further, he counsels and assists clients on becoming eligible for VA benefits and Medi-Cal.

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VA Pension/Aid & Attendance/Medi-Cal

Mr. Miller has been active in the area of VA Pension and Medi-Cal for well over a decade. He uses various specialized types of Trusts as well as non-trust strategies to gain eligibility for his clients and save the family money.

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Probate & Estate Administration

Mr. Miller has been settling estates (both simple and complex) for well over 40 years. The starting point is always to create a strategy to settle the estate in the most efficient manner possible with a minimum of taxes. Often times the strategy created allows the family to bypass Probate Court proceedings.

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Quantity vs. Quality in Your Health…


By merv,

  Filed under: Blog, Estate Planning, Uncategorized

When you create an Advance Healthcare Directive (AHCD) as part of your complete estate plan, you are often asked to imagine the unimaginable.  Some attorneys will give you several options for end of life decisions, such as preserving your life as long as possible at one end of the spectrum and denying all attempts to save your life at the other end of the spectrum.  Several, more nuanced approaches exist, such as withdrawing life support after being in a coma for a pre-determined amount of time.  Still other attorneys will allow you to direct certain types of treatment with an “I would never want x” clause where “x” might be amputation, artificial nutrition or hydration, or cardiopulmonary resuscitation (CPR).

In California, the body of law regarding the right to refuse medical treatment and direct yourself down the path of a natural, if expedited, death has been developing for several decades.  The obligation for the state to protect lives generally, the obligation for physicians to perform needed medical procedures, and the right of the ill individual are often at a crossroads in such cases.  As the law has been developed, the courts have allowed individuals increasing ability to direct their own course of treatment.
In a 1986 case, Bouvia v. Superior Court, a California appellate court allowed a woman with severe cerebral palsy to have a feeding tube withdrawn, despite that fact that she could be expected to live 15 or 20 more years.  In their decision, the court emphasized the importance of allowing a person to determine that his or her quality of life would be so diminished, that his or her remaining quantity of life could be outweighed.  Although it is an extreme case, it is important to reflect seriously about what your quality of life means to you when discussing your AHCD with your attorney, family, and prospective health care agents.  It is also absolutely essential to revisit these considerations as you age.

Similarly, when creating your AHCD, you and your attorney should work together to balance how much flexibility to leave your agent.  Your agent’s authority will generally only be effective once you have lost capacity to make your own health care decisions.  As such, your input may be non-existent at the time when emergency or end of life decisions will be made regarding your treatment and procedures.  Your AHCD is where you allow your voice to be heard.

To that end, you may allow your voice to be a whisper, giving your trusted agent some general guidelines to make decisions as you would, given the facts and circumstances at the time the agent’s decision is requested.  You can temper your agent’s authority with an obligation to consult with other family in non-emergency situations, or obtain a second opinion or allow your agent the autonomy necessary to make weighty decisions without the interference of others.  If you feel strongly about particular courses of treatment, you may also give yourself a louder voice to express the quality of life you require in order for life to be worth continuing.

Your decisions regarding how strongly to state your healthcare preferences may depend on your age, general health, family situation, and agent selection, among other factors.  Thinking about these issues now can alleviate needless physical suffering for yourself and needless emotional suffering for your loved ones.

Estate Planning: The Price of Organization, Rewards, Gifts, and Wondrous Tax Things… FREE REPORT: This complimentary report, focused on Estate Planning, is comprised of many of Mr. Miller’s articles from his long running column for the largest regional newspaper in San Diego County. This report will guide you through the questions surrounding getting your estate planning in order.

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About Living Trusts

About Living Trusts is hosted by the Law Offices of Merwyn J. Miller, as your online resource center to help you explore these key issues, and others, regarding your estate.

Merwyn J. Miller, J.D.

  • Board Certified Specialist in Estate Planning, Trust & Probate Law
  • Co-Author of legal text book and of “Don’t Go Broke in a Nursing Home
  • Teacher of law courses at public and private colleges
  • Continuing Education Instructor for attorneys
  • Columnist for largest regional newspaper in San Diego County and professional journals for 15 years, Contributing author to the book “In Your Service: The Veteran’s Friend”
  • Masters Degree in Financial Services - Estate Planning
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