Dr. Stanley Terman, CEO and Medical Director
Rabbi Martin Levin
Milton J. Wirth, BA, MBA
Carolyn Placente (Advisor)
Chimena Campbell, Secretary and Treasurer
Mary V. Connor
- The Mission:
- To educate professionals and the public about what seems revolutionary now but had been for eons, the conventional way that most people died. People who were extremely ill simply no longer ate or drank. Cancer patients often completely lose their interest in Food & Fluid, and their wishes are respected since they can still speak for themselves. But for those patients who cannot currently voice their wishes, however, others sometimes impose their view of what is on them. The only way to prevent this from happening is to strategically create effective documents while patients still have the capacity to make their own medical decisions.
- To help competent individuals exercise the option of Voluntary Refusal of Food & Fluid which is legally available everywhere, which is peaceful if thirst is controlled, and which all competent patients can use (even those with extreme physical limitations such as paralysis).
- To promote a culture of extended quality of life based on the ironic fact that when people know they can control WHEN they will die, they can and often do decide to live longer. This is especially true for patients who have been diagnosed with early dementia. If those patients can feel certain that an effective plan has been created that others will honor in the future, then they can avoid the tragedy of premature a choice they might otherwise make only because they CAN, rather than because they WANT to die earlier.
- The Means: We can help you explore the options, create documents to empower your Proxy, and help implement your choices of what you consider BEST. Working with you, your family members, and your professional advisers, we can offer our advice and support if you are faced with tough decisions such as when to change the goal of treatment from hoping for a cure to seeking to heal and to comfort, or when to ask your local hospice for help. Discussions with us may lead to implementation by licensed professionals in your home state.
- Permit Natural Dying: A "must" topic to discuss: We encourage dialogue of all points of view to consider whether or not we need to change our state laws about the best way to treat patients who have (in lay terms) lost their minds in other words, who have or will soon lose all personhood. The professional term, "Devastating Irreversible Brain States" refers to three diagnoses: 1) permanently unconscious coma, 2) Persistent/Permanent Vegetative State, and 3) end-stage or advanced dementia. Currently, physicians must presume that these patients wish to indefinitely receive artificial nutrition and hydration. We encourage discussions to consider this alternative: Should doctors be required to Permit Natural Dying; that is, should new laws require doctors to withhold or withdraw treatment that reflects the presumption that patients in Devastating Irreversible Brain States wish to NOT prolong their biologic existence?
- Our policy of respect for your local advisors: The information provided on the Caring Advocates website is intended to support, not replace, the relationship that exists between a patient/site visitor and his/her physician, attorney, hospice provider, religious or spiritual advisor or other professional.
Caring Advocates is a 501(c)(3) non-profit charitable trust established in March 2000.
Caring Advocates' destructibility status can be checked at IRS Exempt Organizations Select Check EIN: 33-0903574
- Medical Team:
- Stanley A. Terman, PhD, MD, Medical Director
- Lofty Basta, MD
- David H. Huffman MD
- Lance Lee Davis, MD
- Ferdinando L. Mirarchi, MD
- Jensen Dillon, RN
- Legal Team:
- Psychology Team:
- Pastoral / Spiritual Team:
Executive & Medical Director
Dr. Stanley A. Terman is a board-certified psychiatrist and bioethicist. He received an AB (Brown University); a PhD (MIT); and an MD (University Iowa). He founded and still leads the non-profit organization Caring Advocates (www.CaringAdvocates.org). Previously, he was on the faculty of University of California, Irvine. The continuous thread of Dr. Terman's professional career is to empower people to make informed decisions so they can successfully meet challenges in their lives with more pleasure, less suffering, and improved relationships. For the last fifteen years, he has focused on reducing the suffering of terminally ill patients and their loved ones, especially those faced with unending, unbearable pain, or the many challenges associated with living with Advanced Dementia. He is passionately motivated to prevent months to years of suffering from unwanted treatment that only prolongs the process of dying, but he is just as passionate about preventing premature dying. His goal is thus to attain timely and peaceful transitions. His clinical tools and strategic forms (the "Ironclad Strategy") were developed in collaboration with prominent colleagues in medicine, law, bioethics and pastoral counseling. He teaches these methods to other health care professionals.
Dr. Terman is the author of a medical-legal thriller about physician-assisted suicide, Lethal Choice, and three non-fiction books about effective Advance Care Planning: (1) The BEST WAY to Say Goodbye: A Legal Peaceful Choice at the End of Life; (2) Peaceful Transitions: Stories of Success and Compassion; and (3) Peaceful Transitions: Plan Now, Die Later—Ironclad Strategy. (The last two are second editions. All are published by Life Transitions Publications.)
Dr. Terman and his colleagues also created the advance care planning tool, My Way Cards / Natural Dying Living Will Cards. (The latter is designed for religious observers.) In addition to illustrated line drawings to increase clarity, this tool uses plain, straightforward descriptions with almost no medical jargon and is written at the third-grade level of reading comprehension. A wide range of patients, even those with some impairment of mental capacity, can use this tool to generate a Natural Dying—Living Will. This document informs physicians and others WHEN to stop interventions that only delay dying, increase suffering and prolong burdens—even if the patient currently has “No Plug to Pull.” This tool can alternatively be used as a “Will to Live,” to request receiving life-prolonging interventions for as long as possible.
Caring Advocates’ approach to future serious illnesses is unique and called the “Plan Now, Die Later™ To Live Longer” approach to Advance Care Planning.
Dr. Terman’s professional articles have appeared in The Lancet, American Journal of Bioethics, Palliative Medicine, Caring for the Ages, Behavioral Sciences and the Law and Hamline Law Review Journal. His most recent article is,It Isn’t Easy Being Pink: Potential Problems with POLST Paradigm Forms.
Paula Span quoted Dr. Terman in her January 20, 2015, New York Times article, “Complexities of Choosing an End Game for Dementia” (Section D; 1).
Michael S. Evans J.D., M.S.W., is an attorney and has been a member of the California Bar since 1970. He is also trained as a social worker. For 13 years he was in private law practice which included litigation involving criminal defense, mental health commitments, and divorce. He taught at the graduate level in the School of Social Work, San Diego State University, and for six years at the University of San Diego Law School. More recently, he served as legal advisor to three right-to-choose-to-die organizations. He authored model Advance Health Care Directives to broaden the range of choices available under California's Health Care Decisions Law and he drafted model legislation to further expand end-of-life choices for Californians. He has served on two bioethics committees in San Diego. He served as critical reader and contributor to sections of The BEST WAY to Say Goodbye: A Legal Peaceful Choice at the End of Life. In the late 1990s he co-founded the Center for Professional Ethics and Law, a non-profit organization which among its projects, examined the impact of court-room advocacy on the professional ethics of expert witnesses during litigation. As legal advisor to the Center, he also counsels individuals on creating and implementing Advance Directives to meet the many challenges of making end-of-life decisions.
Reverend Dennis G. Kuby is an ordained Unitarian clergyman who
lives in Berkeley, California. He was a civil rights leader when serving
the historic Unitarian Society in Cleveland, Ohio, during the 1960s.
After serving as pastor of the Unitarian Church in Studio City, California, he created a specialized Ministry of Ecology that was officially endorsed by the Unitarian Universalist Association in 1974.
His book, Meditating with Marcus Aurelius  explains why the Roman Emperor's pantheistic existentialism has been his guiding light for compassionate ministry. Formerly President of the Bay Area Hemlock Society, and also Head of Hemlock Society of California (End of Life Choices of California), Rev. Kuby also formed Berkeley's Socrates Death Acceptance Fellowship. His active interest in the arts is represented by his also heading the Bay Area Salon Society.
David H. Huffman received his M.D. from the University of Kansas.
Board-certified in both Internal Medicine and Medical Oncology, he spent most of
his career treating cancer patients. He did his residency at Johns Hopkins
before becoming a Fellow and then a Clinical Associate at the National Cancer
Institute. For almost a quarter century, he has practiced in Colorado Springs,
where he was at times, Chief of Medicine and Chief of Staff at local hospitals.
He also was on the faculty of the University of Colorado Medical Center. Among
his many honors are being listed among "Best Doctors in United States" for
1998-2002, and he was granted the "Sword of Hope Award" by the American Cancer
Society in 2001. He has published over fifty articles, some short stories and
poems, and two novels:
SUMMER SOLSTICE , and WINTER SOLSTICE . Work has been completed on his third novel, ASH CREEK ROAD.
Dr. Lofty Basta is an Egyptian Coptic Christian who trained at the Royal Infirmary in Scotland and post graduate Medical School of London and University of Iowa Hospitals. He immigrated with his wife and children to the United States over thirty years ago. Dr. Basta has had a very distinguished academic and practice career, which includes serving as Professor of Medicine and head of the Cardiovascular Section at the University of Oklahoma Health Sciences Center in Oklahoma City, Oklahoma and founder of the Tulsa Heart Center. Most recently, Dr. Basta served as Professor of Medicine and Director of the Division of Cardiology at the University of South Florida College of Medicine, was Chairman at Tampa General Hospital and practiced cardiology at Clearwater Cardiovascular and Interventional Consultants in Clearwater, Florida.
An avid researcher, Dr. Basta has published well over 100 scientific publications in many distinguished medical journals. He is section editor of medical ethics and Member of the Editorial Board of the American Journal of Geriatric Cardiology. He is the author of three books; Cardiology for the Primary Care Physician, Graceful Exit, and Life and Death on Your Own Terms as well as numerous medical textbook chapters on end-of-life care. Dr. Basta's area of special interest lies in medical ethics, particularly in end of life issues.
Lance Davis, MD, MPH is board certified in Family Medicine and serves as Medical Director for the Odyssey Health Care Hospice in Charleston, South Carolina. Dr. Lance Davis is also the Project Leader and co-author of a patient centered guidebook on end of life care called, At The Close Of Day (visit: www.atthecloseofday.com). Dr. Davis serves on several professional advisory committees that deal with end-of-life issues, is an instructor in the ethics curriculum for medical students at the Medical University of South Carolina, and delivers frequent talks and media presentations on the subject.
Dr. Davis' interest in end of life care began in medical school and was honed in residency. He strongly believes that many patients in the modern medical system are "shuffled" through hospitals when they have advanced disease processes. Often, the lengthy conversations and in-depth communications required to orchestrate an effective and compassionate end-of life-plan are simply not held. Dr. Lance Davis strongly believes that prudent advance care planning can lead to vastly improved care and experiences for patients and their families when they must deal with the challenges presented by terminal illnesses.
A veteran of the war in Iraq, Dr. Davis also serves as a Naval Reserve Medical Officer. Lance enjoys active sports, singing and playing guitar, and promoting environmental and social issues.
Dr. Ferdinando L. Mirarchi is chairman of the Department of Emergency Medicine of Hamot Medical Center in Erie, Pennsylvania. He is an assistant clinical professor of the Department of Emergency Medicine, West Penn Allegheny Health System, Allegheny General Hospital , Drexel University School of Medicine. He is also a fellow of the American Academy of Emergency Medicine and the American College of Emergency Physicians.
After completing his undergraduate studies at Temple University in Philadelphia, Dr. Mirarchi graduated from the medical school at Western University of Health Sciences College of Osteopathic Medicine in Pomona, California.
Dr. Mirarchi has been nationally and internationally published in the field of emergency medicine. He has also been interviewed on the subject of living wills by both local and national media, including USA Today, the Associated Press, and ABC News. Dr. Mirarchi serves on the consulting staff for www.emedicine.com.
In his book, "Understanding Your Living Will: What You Need to Know Before a Medical Emergency." Dr. Mirarchi explains, "Many medical personnel see a living will and automatically think a patient doesn't wish to be treated," some equate the existence of a Living Will with a Do Not Resuscitate order, even for patients who condition is reversible. What can you do about this? His book provides the answer.
Jensen Dillon, RN began her career in health care by working as a private duty home health certified nursing assistant in Sarasota, FL (in 2004). Since that time, she has logged nearly 4 years of nursing experience in several areas of patient care: intermediate care of developmentally disabled adults, home healthcare and hospice care.
In addition to her clinical experience, Jensen Dillon also has an academic background that includes two associate's degrees. She graduated from Saint Petersburg College, St. Petersburg, FL with an associate's of arts degree in 2008. She graduated Valedictorian from both practical nursing school (in 2010) and registered nursing college (in 2013) at Galen College of Nursing, Tampa, FL. She was honored for her involvement in a quality assessment and improvement project that focused on infection control and prevention in a community hospital.
Jensen Dillon has strong passion for patient advocacy in regards to patients' rights and patient- centered care. She is dedicated to improving patient outcomes and to do research to establish best practice evidence. Her current professional interests are end-of-life and palliative care, legal nursing, mental health nursing, and encouraging people to complete effective Living Wills for Advanced Dementia.
Philip P. Lindsley, J.D., is Principal and Attorney
of the San Diego Elder Law Center, which he founded in 1997.
He is a widely recognized elder and disability law attorney.
His practice is limited to Medi-Cal Planning and Asset
Protection, Conservatorships and Alternatives, Life Care
Planning, Probate and Estate Administration, and Special Needs
Mr. Lindsley has been designated a Certified Elder Law Attorney (CELA) by the National Elder Law Foundation, the only elder law certification recognized and accredited by the State Bar of California and the American Bar Association. Currently, Mr. Lindsley is one of only 32 Certified Elder Law Attorneys in the State of California.
A native San Diegan, Mr. Lindsley has been practicing law in San Diego County for more than 25 years. He performed his undergraduate and graduate work in Psychology at San Diego State University, and received his law degree from University of San Diego School of Law. He is a former Adjunct Professor of Law at the University of San Diego School of Law. He taught primarily in the areas of Conservatorship and Mental Health Law.
Mr. Lindsley is a member of the Trust, Probate and Estate Planning, and Elder Law sections of the San Diego and California Bar Associations. He is past floor leader of the San Diego County Bar Association's Probate and Estate Planning section of the California Conference of Delegates.
Mr. Lindsley's expertise in elder and disability law, and his passion for the needs of elders, their families and their caregivers, make him a frequent and popular lecturer to professional and lay groups.
Robert M. Gibson, Ph.D., J.D., is licensed both as a psychologist and as an attorney in the State of California. He earned his Ph.D., in 1997 at the California School of Professional Psychology in San Diego, and his J.D., in 1998 from California Western School of Law, also in San Diego. He is currently employed in a large skilled-nursing facility where he provides psychological services, including psychotherapy, cognitive assessment, and assessment of decision-making capacity for patients with a wide range of conditions. These include various forms of dementia resulting from head injury, substance use, progressive conditions like Huntington's disease, AIDS, and Alzheimer's disease, as well as a variety of physical conditions. He also maintains a private practice with a primary focus on the assessment and treatment of addictive behavior.
Dr. Gibson has also been active in writing or revising many of his facility's policies and procedures, addressing issues like advance directives, determination of capacity, surrogate decision-makers, conservatorship, danger to self/others, and various other topics. He is a member of his facility's ethics committee, the San Diego County Bioethics Commission, as well as chair of his facility's Quality of Life Committee. Additionally, he has been a presenter at the American Medical Director's Association (AMDA), California Hospital Association Center for Rehabilitation Services and Hospital Services for Continuing Care, and various other organizations. Topics have included dementia care and have generally emphasized the issue of decision-making capacity in a variety of contexts. Additionally, Dr. Gibson has experience conducting forensic evaluations with the San Diego County Superior Court Forensic Psychiatry Clinic.
Philip Kaushall, PhD, is a psychologist in private practice in San Diego, California. He received his BSc in Psychology from Bristol University, England; his MA from Simon Fraser University in British Columbia, Canada; and his PhD in cognitive psychology from Cornell University, New York. In addition to authoring about ten research articles, he wrote the college text, "The Growing Years" (McGraw-Hill), which covers human development from infancy to old age. He was Assistant Pediatric Research Neuropsychologist in the School of Medicine at UCSD. He has been recognized by the courts as an expert in forensic evaluations in criminal proceedings, and when issues of competence, dangerousness or sanity arise.
As a Diplomate of the American Board of Psychological Specialties in Neuropsychology, he performs evaluations in personal injury and disability cases, including stress and brain trauma that result from accidents, disease factors and assaults, and due to the physical and mental decline of aging. He evaluates a wide range of difficult family issues, such as when assumed authority can be misused, and whether to intervene in the lives of the elderly who seem to be losing their grip on either healthcare or financial decisions. He also evaluates the possibility of undue influence. He is particularly interested in philosophical questions concerning the nature of consciousness and of life itself, which issues have great personal relevance for the elderly and have recently been brought to the forefront of ethical debates by the case of Terri Schiavo and by technological advances in the neurosciences.
Pastoral / Spiritual Staff
The Venerable Mettanando Bhikkhu, M.D., Ph.D., Buddhist monk and physician. His education includes: M.D. from Chulalongkorn,: M.A. from Oxford, England (Sanskrit with Pali and Indian Buddhist Literature); Th. M. from Harvard Divinity School (Medical Ethics, Buddhist Socio-ethical approach to AIDS epidemic in Thailand); Ph.D., from Hamburg, Germany (Meditation and Healing in Theravada Buddhist Orders of Thailand and Laos). He now teaches at five Universities in Thailand and trains doctors and nurses in Thailand in the fields of medical ethics, hospice and palliative care. He teaches healing meditation at Chivasom International Health Resort, Hua Hin, Thailand. He serves as advisor to the Secretary General of Religions for Peace, the largest organization working for world peace through religion. He also represents this organization to the United Nations office in Bangkok. He is the architect of a new healthcare reform in Thailand modeled after his innovative plan to expand hospice, which will be called the Center for Quality of Life, and will emphasize religion, education, and healthcare services. In addition to teaching at five Universities in Thailand, he consults around the world. When traveling outside the United States, he is available by phone and by e-mail.
Rabbi Moshe Levin was ordained at the Jewish Theological Seminary of America. Currently, he is the rabbi of Congregation Ner Tamid in San Francisco, and Rabbi Emeritus of Congregation Beth El in La Jolla, California after serving for 15 years as Senior Rabbi. During his career, he was a military chaplain in Southeast Asia for the U.S. Air Force during the Vietnam War, and held pulpit positions on the island of Curacao (Dutch West Indies), Greater Washington, and Los Angeles. He has a B.A. from Brooklyn College and an MHL from the Jewish Theological Seminary. He was a student of Bible scholar Nehama Leibowitz,, archeologist Yigal Yadin, Israeli philopshpers, Ernst Simone and Rodenstreich. He received rabbinic ordination from JTS Chancellor Louis Finkelstein, H.L. Ginsburg, Isaac Klein, Boaz Cohen, Saul Lieberman, David Weiss-Halivni, and Abraham Joshua Heschel,. His writings include: The Ethical Origins of Kashrut, Near-Eastern Birthrights & the Esau Jacob Narrative, Sexuality in Jewish Law and Tradition, and The Rabbinate for the 21st Century. He is the originator of several new ceremonies in the Jewish Life Cycle, including Shatli Turanita, the first contemporary one ever performed at the birth of a girl. His most recent lecture series is entitled, "A Rationalist's Approach to God, Torah, and Spirituality." Rabbi Levin is working on a book describing the uniqueness of Jewish spirituality.
Rabbi Levin, who is the father of six children, has an interest in end-of-life issues that is both professional and personal. His thirty-seven years in the rabbinate has brought him face-to-face with countless congregants, as they prepared for and dealt with their last transition, or that of their loved ones. On a personal level, sixteen years ago he was diagnosed with lymphoma and expected a maximum of only about eight years more. Having lived with thoughts of his own end-of-life decisions for all these years, he has come to believe that confronting death has made living far more meaningful. His enduring enthusiasm for life continues to inspire people of many faiths.
Rev. Dr. Christina Tillotson is a staff minister at Seaside. She teaches classes, speaks occasionally, and leads the Seaside Sage Connection, which serves people in the "better half" of life and those who love them. Christina's full-time Ministry is Distance Dean in charge of On-Line Education for United Church of Religious Science Headquarters and Distance Learning for the Holmes Institute.
Christina became a Religious Science Practitioner in 1987, a Minister in 2003, and was ordained in 2006. She has a BA in Social Work, an MA in Education, an MA in Consciousness Studies, and earned her Doctorate in Divinity in 2003.
Christina's passion is education. She has been a public school teacher and administrator, a community college instructor, a training manager for a software company, a business and marketing trainer and consultant, and an Internet trainer and consultant. She is honored to use these skills as a Minster at Seaside and at United Church of Religious Science to spread Science of Mind throughout the world. She frequently holds classes on the use of the "Five Wishes" as a way to help planning for how we want to die, and interest which stems strongly from her personal experiences.