The Living Will Handbook: The Right to Decide Your Own Fate
Books / Paperback
ISBN: 0803893345 / Publisher: Hastings House Pub, November 1991
Discusses different aspects of creating a living will which determines the action to be taken if life-prolonging healthcare is required
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Western Society has always stressed the sanctity of life and to uphold this tradition doctors go to great lengths to keep patients alive. Since the 1960's, medical technology has made great advances with the introduction of new high-tech equipment that is able to keep people alive for longer and longer periods of time. Some equipment, such as respirators and feeding apparatus actually prevent some patients from dying, particularly those in a coma who can be kept alive on these machines indefinitely.This situation has brought about a growing reaction from many people who feel that everyone has a right to die with dignity. The case of Karen Quinlan is a case in point. Her story made headlines in 1971. Karen's brain had been severely injured. Machines kept her alive although she was in an irreversible coma.Because there was no chance Karen would ever recover, her parents asked the New Jersey courts to allow the respirator to be removed. The court agreed, the respirator was removed and it was expected that Karen would soon die. But after the respirator was removed Karen did not die. Even without the respirator she lived for six more years, kept alive by a feeding apparatus and hydration. Had there been an advance medical directive, a Living Will, directing that her physicians should not keep her alive if she was in a permanent vegetative state, there would have been no need for Karen Quinlan's parents to go to court.This necessity for a Living Will was further highlighted by a similar case which resulted in the 1990 U.S. Supreme Court decision in Cruzan v. Director Missouri Department of Health. In 1983, Nancy Cruzan was in an automobile accident and suffered irreversible brain damage. While her body lived the thinking parts of her brain were permanently destroyed. In this case Nancy's parents sought to disconnect her feeding apparatus and discontinue hydration. In the absence of an advance medical directive the hospital refused to do so without court approval. The lower court approved Nancy's parent's request. The hospital staff appealed the lower court's decision. The Missouri Supreme Court then reversed the lower court on the basis that Nancy had left no written evidence of her desires.Finally, the U.S. Supreme Court voted to uphold the lower court after hearing testimony from three additional witnesses that proved "clear and convincing" evidence of Nancy's desires. It was affirmed that a competent patient may refuse medical treatment, and an incompetent patient, if there is "clear and convincing" evidence of his or her wishes while competent, can withhold or withdraw any life-saving medical aid.After December 1, 1991, the Patient Self-Determination Act is law. That Act states that any health-care facility receiving medicare or medicaid funds is obliged to advise patients of their right to sign an "advance medical directive" (a Living Will) or select a proxy who will make life and death decisions for them.
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