Living wills are unnecessary and dangerous for patients, doctors and society. See alternative advance medical directives information.
Living Wills are documents being promoted as necessary to provide assurance that people will die peacefully and with dignity. Learn the facts before you sign a Living Will or support laws making Living Wills legally binding documents in your area.
What is a Living Will?
- A Living Will is a document by which a person can give in advance a directive to have life-sustaining medical treatment withheld or discontinued at the time of future serious illness or injury should he or she be unable then to make medical decisions.
- Living Will language is deceptive. Simple wordings appear harmless until the meanings of the words are analyzed. Words such as "artificial means," "reasonable expectation of recovery," "relatively short time," "heroic measures" and "terminal" are open to a variety of interpretations. Many of the meanings that could be construed from these words may be contrary to the intent of the Living Will signer.
- Also, there may be more provisions to a Living Will than the simple declaration which is signed by the individual.
Why are Legally Binding Living Wills Unnecessary?
- People already have the right to make informed consent decisions telling their family and physicians how they want to be treated if and when they can no longer make decisions for themselves.
- Doctors are already free to withhold or withdraw useless procedures in terminal cases that provide no benefit to the patient. Some people fear that medical technology will be used to torture them in their final days. But it is more likely that the "medical heroics" people fear are the very treatments that will make possible a more comfortable, less painful death.
- Doctors do not need Living Will laws to be protected from malpractice suits. However, if Living Wills are legally binding an attending physician who fails to comply could be sued or prosecuted.
Why are Legally Binding Living Wills Dangerous for Patients, Doctors, and Society?
- Living Wills are so vague that they are open to many abuses.
- It is not possible to make well-informed decisions about treatment before an illness or injury occurs. Special circumstances at a future time will affect decisions concerning treatment.
- To direct in advance that health-care personnel withhold or withdraw all "life-sustaining" treatment at some unknowable future date under unspecified circumstances makes a mockery of informed consent and hinders the practice of good medicine.
- When a patient who had signed a legally binding Living Will becomes unable to make decisions, the doctor and family may be unable to make medical decisions that are in the best interests of the patient because the document strictly limits their options.
- A Living Will would not authorize withdrawing extraordinary life-sustaining treatment only. Under a Living Will law that all states are being urged to adopt,1 health professionals are authorized (and could even be required) to withhold such ordinary care as food and water. Persons seeking to prevent "extraordinary" and "heroic" measures at the end of their lives may unintentionally authorize their own starvation and dehydration.
- A Living Will locked into law would apply not only to the very elderly. A healthy person signing such a document cannot foresee what circumstances might call it into effect. For instance, one might want to refuse "heroic" treatment after a struggle with cancer at an advanced age, but welcome aggressive treatment if injured in an auto accident at a younger age. Legally binding Living Wills would make no distinction.
- Living Wills are intended to go into effect when people are "no longer able" to make treatment decisions for themselves. But there are no objective criteria in Living Wills for making such a determination of incompetency.
- Under laws recognizing Living Wills, when there is some question about whether the patient is terminally ill or not, the safest course for the physician would be to withdraw all life-sustaining treatment rather than attempt to preserve the life of the patient and risk being sued for failing to carry out the Living Will.
Should Every Treatment be Applied to Every Patient in Every Circumstance?
No, of course not. Neither present law nor the moral position of any church nor any right-to-life organization requires that every form of treatment be applied to every patient in every circumstance. If a patient is imminently dying, it is both good medicine and good morals to withdraw useless treatment that would only prolong the dying process with no benefit to the patient.
But, there is an alarming trend to define food and water as "medical treatments" which can be considered optional for a given patient rather than ordinary care to which all are entitled.
- Today patients are in more danger of under-treatment than overtreatment, especially dependent persons in institutionalized situations. There are now major financial incentives for health care providers to undertreat patients.
- Living Wills weigh the law in favor of death rather than life. They do not give the patient the power to direct that he or she be given life saving treatment or even food and water.
- Presently there is a rapidly-growing trend to withdraw beneficial medical treatment and food and water from incompetent and even non-terminal patients. What is needed is protection for persons, rather than legislation authorizing their death by starvation and dehydration.
The concept of the Living Will originated with organizations such as Concern for Dying (formerly known as the Euthanasia Education Council), the Society for the Right to Die (formerly known as the Euthanasia Society of America), and the Hemlock Society.
The strategy of these groups is to use Living Wills to condition public acceptance of assisted suicide, mercy killing, and legalized euthanasia. This has happened in the attempted referendum in California in 1988, that failed due to lack of sufficient signatures.
"Euthanasia forces are abroad in this land as never before ... the euthanasia movement is assuming the proportions of a juggernaut."
Dr. C. Everett Koop
United States Surgeon General
Footnote:
1 "Uniform Rights of the Terminally Ill Act" adopted by the National Conference of Commissioners on Uniform State Laws, August, 1985.
Advance Medical Directives Information
