It is one of the few times in my life I have ever felt guilty for letting someone down.

And it was the person that I was the closest to - my mother.

I was visiting her in Lincoln in March of 2006 when my older brother had to make a run to a pharmacy in Roseville. We went with him.

We stayed in the SUV when Richard went inside. The second Richard had shut the door and started to walk away Mom told me she had something important to ask me.

She was afraid when the time came that my other two brothers and sister - who saw her every day as they resided in Lincoln - wouldn't follow her wishes. I had no idea what she was talking about.

Then she told me that I was always the "pragmatic one" and would understand what she was about to ask. Her request was simple. Mom, who had suffered a stroke a year earlier, told me that she just wanted to die if she suffered a major stroke as she didn't want any extraordinary steps taken to keep her alive. And, she added, in no circumstance did she want to be put in a convalescent hospital. She wanted to die at home.

I was stunned. I knew my mother would die eventually - we all do. In a way we all are plugged into the dying process the moment we're born. It's the cycle of nature. Still I wasn't expecting 45 minutes into my visit with my 82-year-old mother who I hadn't seen in nine months was going to be discussing her death.

I didn't hesitate more than a second or two. After all, how could I not honor a simple request from a woman that gave me life, changed my diapers, taught me how to walk, comforted me when I skinned my knee and heart, and loved me unconditionally?

Then that "pragmatic" thing kicked in. I told her she really needs to put it in writing so everything was legal and proper. She said there was no need as she trusted me.

I persisted. It was the only way her wishes would absolutely be followed if there was push back from any of my siblings. Mom said she had mentioned it to my sister who mirrored my thoughts that our brothers would balk.

Just before Richard returned, I told her I'd contact a lawyer to try and set up an appointment within the month. She was fine with that.

Two weeks later my sister called. Mom had taken a turn for the worst that morning. At the hospital they sat down with Dr. George Scarmon. When the prognosis was laid out, one of my brothers balked asking if there was any chance. I was told the doctor said there was always a chance. Long story short, my mom was sent to a convalescent hospital. I wanted to come up right away but was told Mom preferred that I not come until that Friday.

Two days later, I got an early morning phone call. Mom had passed away. She had died where she didn't want to die. The grief was overwhelmingly but the guilt started to rain and run a close second. I had let my mom down. She made one simple, rationale request and because I didn't act fast enough I had failed her.

I found out more about the dynamics of dying and the world we live in where people will sue at the drop of a hat. Rarely will you find a physician willing to jeopardize the wrath of a lawsuit - in absence of clear, written and ironclad legal instruction of a patient - from a close relative such as a spouse, parent, or child when one of them insists you do everything possible to keep a person alive.

My initial reaction to the news that Barbara Bush made it clear that she no longer desired aggressive treatment for lung and heart disease was that such a private matter shouldn't be splashed all over the news.

But then again it was likely sticking with what Barbara Bush wanted. She was no shrinking violet. As First Lady when most of America recoiled at the mere mention of HIV and AIDS she used her position to become an activist pushing for people to deal with reality and be human.

Nobody likes talking about the impending death of a loved one.

But it is clear such conversations are necessary on a variety of levels - emotionally, spiritually and physically.

The hardest thing to grasp is that it's not our death but that of a loved one. Too often love blinds you to the painfully obvious. We end up insisting on things that may do little if anything except prolong life for a few days or weeks with higher levels of excruciating pain and misery.
Mom was the type to point out the questionable squandering of costs and resources. Dying is not cheap when it's done in a setting where it is clear to almost everyone in the room that it is inevitable but someone other than the patient insists all measures be exhausted.

Yes, there is a big difference between a 92-year-old woman such as Barbara Bush in failing health and a strapping 15-year-old dropped on the threshold of death's door due to a sudden, horrendous mishap. That is exactly why the wishes of the person who is in failing health in relation to ongoing medical care must not only be respected but assured through taking required measures that pass muster to legal challenges so healthcare professionals can honor the wishes of their patient.

This column is the opinion of Dennis Wyatt and does not necessarily represent the opinion of Morris Newspaper Corp. of CA.