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January 5, 2006

The irony of promoting living wills

Topics: Living Wills

The most significant sentence in this entire article is the last one:

Most states, Washington and Idaho included, do not require hospitals and doctors to comply with the directives in every situation.
Consider a situation in which a patient has a written directive, declaring that their medical treatment desires are in favor of survival and life-prolonging treatment. In most states, can a doctor, a hospital ethics committee or a nursing home risk management department now deny those treatments under 'certain circumstances'?

I find it ironic that living wills are so heavily marketed as the solution for these debates when this article admits, in closing, that they aren't. I can't help but think about Leslie Burke in UK who fought in court for the enforcement of his own advanced directive - directing that nutrition and hydration be continued if or when his disease leaves him unable to communicate. Ultimately, it was treated by the courts as an illegitimate concern. I rather suspect if Mr. Burke had a living will directing the withdrawal of those provision, he would never have heard a peep out of anyone. It would have been thought of as legitimate and his right.

To me, this says: "If you want to check out, we're behind you 100%. But, if you want to have a go at life, you're on your own." And that's no way to treat someone who is at the mercy of others.

Source: Pamela Hennessy

Posted by tim at January 5, 2006 8:10 PM

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Yes, most states allow doctors to refuse almost anything. National Right to Life did an interesting report on this recently. In fact, the much-maligned Texas law that gives ten days' notice is good by comparison with some other state laws, because you have the ten days to find another facility.

The idea is to protect a doctor's conscience, which is good if the "treatment" the person is requesting is something bad like abortion--any doctor should have the right to refuse.

But we need to be able to say openly that food and water are different, are not treatment, and that a doctor cannot refuse to give them to a patient, so long as that person _is_ his patient, any more than he can order the nurses not to wash the patient. Basic care is basic care, not a matter of the doctor's "conscience."

By the way, I have had a lawyer try to tell me that whether food and water are designated "treatment" or not is legally unimportant. This shows why he is wrong: A doctor can refuse _treatment_, and a patient can refuse _treatment_. If these things are designated as basic care, they are not things a doctor can refuse to give on phony "conscience" grounds.

Posted by: Lydia [TypeKey Profile Page] at January 7, 2006 4:08 PM