Abby says living will good.  But watch out!

RARTL logo

Rochester Area Right To Life

“Dear Abby” says you should have a living will  But watch out!

In her Tuesday, April 12 column, Abby says you should have a living will to instruct the people in your life about your wishes “if there is no hope for your recovery and you are unable to speak for yourself.”

She furthermore says that “Anyone with problems having an advance directive honored should contact the Compassion and Choices support staff” who “will advocate for honoring your advance directive, including legal action if necessary.”

There are several aspects of this approach to advance directives that you should approach with thoughtful caution.

Additional explanations:

Why Not Sign a Living Will Instead of the Will to Live?   (http://www.nrlc.org/
euthanasia/willtolive/WhynotWTL.html  )

I live every day in the bulls-eye of euthanasia, always aware that I am a target for "mercy killing." Just one sickness, medical emergency, or accident separates me from those who would kill me and call it "death with dignity."  

(www.nrlc.org/euthanasia/
willtolive/Cockfield.html

 

1.  Changes in medical establishment assumptions. Fifty years ago, doctors fought tooth and nail to keep their patients alive, sometimes long past the time that the patients wished to be kept alive.  The pendulum has swung the other way, to the point that the presumption now is that if your condition is going to leave you with a poor “quality of life,” whatever that means to the person doing the deciding, that you would prefer to be dead.  Furthermore, managed health care, insurance companies, and HMOs have to be concerned with their financial “bottom line.”  Unlike that doctor of 50 years ago, they have no bias toward keeping you alive.

In anything you write, be wary of such vague terms as “recovery” (to what level?) and “quality of life,” (my definition or yours?) since they could be a death warrant.

2.  Potential biases in advice.  A look at the Compassion and Choices website(s) shows a logo for the Hemlock Foundation on one of the two home pages.  Among other tools there is a letter to your doctor intended for you to “print out and use to start a conversation between patient, family and doctor” regarding your care at the end of life;  it directs that if circumstances warrant “I therefore request that my physician will provide medications that I can self-administer to help my death to be as gentle and timely as possible.”  The letter argues that ethical standards are changing, so that self-administered medication to “hasten death” may not necessarily be a risk for the physician.

Clearly their presumption is that there are a significant number of circumstances where one would wish to commit suicide.

If a one is in favor of assisted suicide, then perhaps the Compassion and Choices group is the right place to get assistance.  If one is not in favor of assisted suicide, then it is well to be aware of the philosophy of the group in assessing any information or help one might get from them.  But in any case, be aware that physician-assisted suicide is currently legal only in Oregon.

3.  Things change.  Advance directives have a major disadvantage – they are made well in advance and when they are part of a legal document they may be cast in stone.

Consider the case in Rochester where a woman had previously signed an advance directive, with her daughter as the health care agent, only to discover when the time came that the directive was going to deprive her of supplementary oxygen, antibiotics, and food and water, with a guaranteed Schiavo-type of death within two weeks.  The woman was not legally capable of revoking the advance directive and in spite of her fear and her daughter’s objections the hospital was going to carry out the directive.

Emergency legal help produced treatment for several months, long enough for her to die naturally and at peace and for her family to be at peace, too.

Circumstances change and our opinions do, too.  Rather than the standard Living Will you may want the Will to Live, to provide for maximum flexibility.

4.  Will to Live.   This is a combination of advance directives and health care proxy, but it makes the assumption that you want to live, which needs to be explicit because of point #1 above.  It does leave room for you to customize it.  The appointment of the health care agent is a key factor in assuring that your wishes will be carried out.

First, download and print the Will to Live for your state from the website of the National Right to Life (www.nrlc.org ).  Read the explanations carefully, all five pages, and think in detail about what you want to have happen under a variety of realistic circumstances.  For instance, it is not possible to be brain dead and in pain.  It is not possible to be in a persistent vegetative state and worried about your family or frustrated at not being able to walk or talk.  Taken one at a time, these are issues to think about and discuss with your agent.

Select a health care agent who can work within your preferences, someone who is responsible, someone you feel comfortable with.  Then fill out the form, being careful not to rule out treatments that the agent might decide you should have.  Remember, it will probably be easier for the agent to convince the HMO not to do a treatment than it will be to convince them to institute treatment.

Get the form signed and witnessed and then make sure your whole family knows what you have done.  Give a copy to your doctor.  Keep one with your personal papers – not in a safe deposit box!  Give one to the person you have named as your health care agent.  Depending on circumstances, a copy to trusted family members might also be a good idea.

If you’ve done this, you have now done yourself and your family a big favor.  Pat yourself on the back!

RARTL Updated April 15, 2005


General Information Online

Annotated Pro-Life Links Statistics Find Your Lawmaker Legislative
Status in NY
Fed Voting Recs NYS Voting Recs Thoughts Pamphlets, Books,Gifts Archive

Right to Life Website - Main Headings

Home What's New Local Events Life Stage
Help
About Us Education
Rochester
Gen Info
Online
How You
Can Help

Tell
Us

TOC