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Living Will: Spare the Food, Pass the Drugs

By Jeralyn, Section Civil Liberties
Posted on Mon Mar 21, 2005 at 08:19:50 PM EST
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Last night I began filling out the form for my living will advance directive. I didn't finish because I got stumped in the middle by whether what I was directing would be allowed. Jeff Jarvis had the same thought today.

If I wrote my living will with explicit instructions [again: I'm not going that yet] saying that I would want life support removed but only with sufficient narcotics to cause death, what would doctors and courts do then?

Do we all have to move to Oregon? And if Bush is successful in the Supreme Court this fall overturning Oregon's physician-assisted suicide law, do we all have to move to Amsterdam?

Update: Thoughtful reading abounds in the blogoshphere. Check out Kevin at Lean Left and Bad-Meme A'Rising.

The Philadelphia Inquirer addresses the constitutional issues with the law passed yesterday,

< Republican Talking Points on Schiavo | Michael Jackson: Comedian to Describe Relationship With Accuser and Family >

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    Living Will: Spare the Food, Pass the Drugs | 13 comments (13 topical)
    Re: Living Will: Spare the Food, Pass the Drugs (none / 0) (#1)
    by Talkleft Visitor on Mon Mar 21, 2005 at 08:45:23 PM EST
    Living will is a bit of an out-of-date term. Current standard is advance directive to physicians and medical power of attorney. I have both, but only want my spouse/poa to have my advance directive. She can produce it if necessary, but otherwise she knows me better than anyone and I trust her judgment. I am not sure she can be as forceful as could be required to keep the doctors and machines away from me, so my youngest daughter is also prepared to step in and see that my wishes are carried out. I may need to add a clause to the poa and advance directive that specify that I formally and unequivocally reject any assistance from any elected body, person, or agency other than my appointed agents. Get your wishes and desires down in writing folks. That's the real lesson of the awful Terry Schiavo situation. Congress is not the great deliberative body you want helping you with end of life decisions.

    Re: Living Will: Spare the Food, Pass the Drugs (none / 0) (#2)
    by Talkleft Visitor on Mon Mar 21, 2005 at 11:08:42 PM EST
    Exactly, Jeralyn. If they can void the measured deliberation of the courts, they certainly can find excuses to override anyone's advance directive. That's the way it is under a rule of men rather than law.

    Re: Living Will: Spare the Food, Pass the Drugs (none / 0) (#3)
    by Talkleft Visitor on Tue Mar 22, 2005 at 12:26:39 AM EST
    Colorado, at least, gives you quite a bit off latitude for setting your own "pull the plug" threshold, and drug threshold. My dad's DMPA says, in part, "My comfort and freedom from pain are important for my agent and physician to protect, insofar as possible. I authorize my agent to consent on my behalf to the administration of whatever pain-relieving drugs and surgical pain-relieving procedures my agent, upon medical advice, believes may provide comfort to me, even though such drugs and procedures may lead to pharmaceutical addictions, lower blood pressure, lower levels of breathing, or may hasten my death. Even if artificial life support or aggressive medical treatment has been withdrawn or refused, I want to be kept as comfortable as possible, and I do not want to be neglected by medical or nursing staff." His Living Will states that he wouldn't want life support of any kind if his agent, upon medical advice, determines that there isn't a reasonable expectation that he will recover to the point where he can sit up and use a computer and do his job as an engineer. The only part the hospital lawyers had a problem with was the second part, because they didn't feel qualified to determine what level of function an engineer would need, so they had him sign an addendum that said it was his agent's (my) responsibility to make that determination.

    Re: Living Will: Spare the Food, Pass the Drugs (none / 0) (#4)
    by Talkleft Visitor on Tue Mar 22, 2005 at 05:24:59 AM EST
    Exactly right, Mr. Ditto. Detail in the document and power to the agent. Good luck if you actually have to carry out the pull the plug part. Doctors, hospitals and long term care facilities are very reluctant to remove the machinery once it is in place. You can have the authority to demand it, but you may not find a physician or technician willing to carry out your directives. Worse, now you may have Congress asking about your motives and bringing their culture of life to your family. Pompous, arrogant fools.

    Re: Living Will: Spare the Food, Pass the Drugs (none / 0) (#5)
    by Alice on Tue Mar 22, 2005 at 08:37:53 AM EST
    When my grandmother was in the hospital a few years ago (in North Carolina), we couldn't find a copy of her living will. The hospital told us it was just as well, since they were generally useless there. We were told that unless it was written exactly according to the individual hospital's guidelines, they would not recognize it. My grandfather did have the right to take her off her ventilator, but there really weren't a lot of grey areas with my grandmother. My advice: Check with the individual hospital(s) you may end up in and see what they require.

    Re: Living Will: Spare the Food, Pass the Drugs (none / 0) (#6)
    by Dadler on Tue Mar 22, 2005 at 10:28:29 AM EST
    move to amsterdam if you're planning on dying soon. or wait it out here in the states. probably be about thirty-fifty years before we catch up and overcome our puritan origins regarding sex and death.

    Re: Living Will: Spare the Food, Pass the Drugs (none / 0) (#7)
    by Talkleft Visitor on Tue Mar 22, 2005 at 04:51:55 PM EST
    Alice: University Hospital tried to pull that with us as well. Our attorney consulted with them as a courtesy, but the legal documents were written by my dad and his lawyer. The hospital's paperwork had what basically constituted a malpractice waiver and an agreement not to sue under any circumstances. our version has a clause that indemnifies the hospital only in the case that I chose to exercise the advanced directive. We were not about to sign away all liability as he headed into a double lung transplant. According to our lawyer their requirement that we sign their version of the living will with the waiver would have rendered the waiver unenforceable since it was completely under duress. So he brought that up with the hospital lawyers and they caved without any push-back at all.

    Re: Living Will: Spare the Food, Pass the Drugs (none / 0) (#8)
    by Talkleft Visitor on Tue Mar 22, 2005 at 08:49:43 PM EST
    et al - Having just spent 6 lovely hours with a local hospital with my Mother, who is 90 and has just fallen and broken her shoulder, I can say that my mistrust in the medical profession and its management has again been confirmed. I have also, again, become convinced that you can be educated far beyond your intelligence.

    Re: Living Will: Spare the Food, Pass the Drugs (none / 0) (#9)
    by Talkleft Visitor on Tue Mar 22, 2005 at 09:05:21 PM EST
    Jim, do you or your mother have advance directives or medical powers of attorney?

    Re: Living Will: Spare the Food, Pass the Drugs (none / 0) (#10)
    by dead dancer on Wed Mar 23, 2005 at 04:40:25 AM EST
    Jim, Hope your mom is feeling better.

    Re: Living Will: Spare the Food, Pass the Drugs (none / 0) (#11)
    by Talkleft Visitor on Wed Mar 23, 2005 at 06:11:53 AM EST
    CA - Yes. dancer - Thanks. dadler - Life doesn't phone ahead. You know, I think too many believe the issue is Living Wills. I think that for many who oppose what has happened is that we don't believe the husband, and there isn't a Living Will. Without one, no tube should be pulled, no plug pulled on ANYONE's word. And even if I believed this husband, I would not agree. The possibility for mischief is far to great, for error far too great.

    Re: Living Will: Spare the Food, Pass the Drugs (none / 0) (#12)
    by Talkleft Visitor on Wed Mar 23, 2005 at 06:36:29 AM EST
    The courts have decided otherwise Jim on many occasions. Advance directives and medical powers of attorney are the preferred method, but absent such instruments there is a well-established decision-making hierarchy that the courts have followed scrupulously in this case. It's unfortunate that this person did not leave a written record of her wishes, but it's not unusual. We do not keep people on life support means just because there is no written instrument.

    Re: Living Will: Spare the Food, Pass the Drugs (none / 0) (#13)
    by Talkleft Visitor on Wed Mar 23, 2005 at 06:58:41 AM EST
    CA - Like many things in life, the devil is in the details, and all people in all professions, including judges, often let their ego get in the way of doing what is right. I think the system has failed. I think their should be no turn off of anyone at anytime without specific legal written instructions, no matter how wonderfully the judical system thinks it is, or thinks it works. And if the judges involved used some common sense, they would insist on the tube being inserted, and that they start over, with all parties involved being heard, under oath, on the stand. Why? Because the system has been challenged, and because foes of the system will use this case to demonstrate arrogance and a stickler for process rather than fair results. That is deadly for any organization, and corrodes the foundations of our system of government. It is another case of someone winning the battle but loosing the war.

    Living Will: Spare the Food, Pass the Drugs | 13 comments (13 topical)