I've talked with experts about the struggles families endure as they make medical decisions for loved ones who can't speak for themselves. The stress of the decisions is compounded by old family wounds that resurface.

Today's story about a guardianship hearing for 85-year-old Al Barnes is extreme. Intimate family business rarely spills out so publicly. But it also reflects hardships that many families face. My question: Have you struggled with this type of family decision-making? How did you get through it?

While Barnes in 1993 elected his wife, Lana, as medical decision-maker, Methodist Hospital is seeking to replace her because she is demanding treatment that doctors believe is futile and unethical.

During the hearing, Lana Barnes cross-examined two stepsons, who disagree with her requests for aggressive care. The wife (representing herself in court) asked them why they hadn't visited much, implying that they haven't been close enough to their father to have a say.

"I have felt you have not wanted the sons from Al's first marriage to be around," replied one stepson, Clint.

"You know, you could have talked to him if you wanted to," Lana later retorted.

She asked the other stepson, Jim, "Where have you been for 17 years?"

Jim told how he had been excluded by Lana from a hospital care conference over his father. He has been distant from Lana ever since she married Al 27 years ago. James declined to stand with his father at the wedding, because it occurred weeks after his mother died of cancer.

In an interview, James told me he had differences with his father, but that his dying mother asked him to look after Al. "I made a promise to my mother. I didn't know when it was going to come. I think it's here."

This isn't just "stepsons versus stepmom." Dan Barnes called me from Idaho to support his stepmother's view that life-sustaining care is needed for his father: "I don't know why any doctor who signed on oath of practice would refuse treatment from anybody," he said.

Readers have asked whether selfish motives are at work. Al Barnes does have a will dividing up shares of his farmland in Scandia, Minn., Jim told me. But the relatives just think this is a dispute over what's best for Al.

So there you have it. A family dispute with medical, religious, philisophical and practical conflicts. It has brought out differences that have simmered 30 years. Extreme? No doubt. But I'm betting readers can find traces of it in their lives.