Wednesday, April 27, 2005

USATODAY.com - Living wills go out socially

This USA Today article is by Janet Kornblum. It was posted 4/27 7:11p.m., with a 4/28 12:58 a.m. update:
Lingerie, Tupperware and murder mystery parties. They've been the rage for years. Now add a new one to the list: living wills parties.

Some Americans, prompted by their desire to avoid the problems that surrounded the Terri Schiavo case, are gathering at parties where they balance their chardonnay along with clipboards holding living will forms...
Down toward the end of the article is this:
People may be overly concerned about ending up in a Schiavo situation, says Carl Schneider, a law professor and bioethicist at the University of Michigan Law School.

He calls Schiavo "the great exception" rather than the rule.

Schneider says living wills often are ignored and simply don't work because it's difficult to anticipate all the medical possibilities. Instead, he recommends only designating a medical decision maker.

At worst, critics say, living wills can be dangerous because doctors, in the thick of an emergency, can misinterpret the documents to mean a patient does not want treatment.

"Often in emergency medicine, we have seconds to minutes to act," says Ferdinando Mirarchi, chairman of the department of emergency medicine at Hamot Medical Center, Erie, Pa. "And if we don't act, that patient can suffer some serious disability or possibly even die."

He has written What's the Patient's Code Status?, a guide to help people be specific about their end-of-life wishes, available at livingwillconsultants.com. But he feels so strongly that uniform advance directives can do damage, he says, that he has refused to help large groups fill them out.
There is a sidebar to the article in which advice is given on how to host a living-will, or "advance directive" party. A handful of organizations that provide documents or guidelines are listed, but I don't see National Right to Life's Will to Live program mentioned. That one is designed to have safeguards built in, so that you're not as likely to find your fate dependant on your medical provider's personal definition of "meaningful life". See http://www.nrlc.org/euthanasia/willtolive/WHYwtl.html

I don't think this next point can be repeated enough. What advocates for disabled people keep saying is that most people vastly underestimate their ability to overcome difficulties, and vastly overestimate how much any given disability would affect their life. They say that of course there is a period of adjustment for newly disabled people - but then people generally find out that they're stronger and more adaptable than they realize, and that life is still precious. You might want to bear that in mind before you quite literally sign your life away on the basis of being afraid of possibly having to deal with some tubing someday.

Tubes are minor. Being killed by some 'death with dignity' zealot after you've realized that you're still willing and able to hang in there is huge. Some of those 'living wills' floating around out there are literally 'get out of jail free cards' for euthanasia advocates. I guess the bottom line is this - do you want your signature protecting them, or you and the people who love you? Please be careful what you sign.

1 comment:

Anonymous said...

Excellent points.

Just saw this.

Remember livings wills today , do to the structure of how they are created have the potential to harm you rather than protect your right to choose. In this artcile someone said they would rather have a bad plan then no plan at all! That is fine for a buisness model but when it is appliaed to a human model with respect to medical care the only thing a bad plan gets you is dead!

Living wills have threee critical problems:
1. The are not Individualized
2. They lack informed consent- Case in point is this living will party. People have a glass of wine an appetizer and then sign a document which can compromise their care and safety.
3. They are misinterpreted to mean they patient would not wish to recieve treatment.

The only way people can created these critical flaws is to know and understand the question "What's The Patient's Code Status?"

Dr. Ferdinando L. Mirarchi, FACEP, FAAEM
Chairman
Department of Emergency Medicine
Hamot Medical Center