A Cautionary Tale About "Living Wills" -- Part One of Two

The headline on the op-ed in Sunday's Washington Post accurately caught the author's sentiments: "BACK OFF! I'M NOT DEAD YET. I Don't Want a Living Will. Why Should I?" [www.washingtonpost.com/wp-dyn/content/article/2007/10/12/AR2007101201882.html] 

Charlotte Allen is someone who I have read with delight for many years. She is a gifted journalist and author, with a flair for not being flamboyant. Wherever/whenever her essays appear, the reader knows he is in for a treat.

The inspiration for Ms. Allen's very thoughtful and provocative 1,706-word-long op-ed was a trip she made last year to a hospital. She'd come in for treatment of an early-stage breast cancer, which is, as she explained, "noninvasive and thus not particularly life-threatening if promptly attended to, and the required outpatient surgery isn't especially risky."

But "one of the shoals I had to maneuver through at the hospital (which otherwise afforded me excellent care) was a series of efforts to persuade me to sign on to the currently fashionable notion of a 'good death.'" That would be signing a "living will."

The premise, unspoken or otherwise, of such wills is the exact opposite of NRLC's Will to Live. A Will to Live emphasizes what the person does want done on their behalf.

By contrast, generally a living will tells the staff in excruciating detail what they supposedly don't want done. That, of course, is the rub.

When the rubber hits the road--when individuals are dealing with concrete medical emergencies--people often let staff know they now want what they previously said they didn't want in their living will.

And that doesn't address the less-than-subtle coercive power of a document that is not only embedded with don't- treat-me assumptions, but is also a complex document which (as Allen notes) "cast[s] a negative pall upon positive efforts to keep me alive."

All this, expected to be completed in about in about 30 seconds, "did not inspire my confidence in the living-will industry."

The first time Allen was asked if she'd signed a living will, "I found the box on the form that said 'I decline a living will' and checked it. Right now, my husband is my living will, and after we spent 13 days observing Terri Schiavo exercise her 'right to die' by being slowly dehydrated to death after her feeding tube was removed in 2005, he knows exactly how I feel about such matters."

Twice more she was asked the same question. This got Allen to pondering the big questions, including how much is hidden in gauzy talk about a "good death/dying well."

This is a long quote, but a good one from Ms. Allen,

"In fact, when I contemplate the concept of 'dying well,' I can't avoid the uneasy feeling that it actually means 'dying when we, the intellectual elite, think it is appropriate for you to die.' Consider what's happened in recent years: The classic Hippocratic Oath and its prohibition against physicians giving people a 'deadly drug' has collapsed with the growing acceptance of such notions as physician-assisted suicide, the 'right to die,' and even giving some very sick, disabled or demented people a little push over the edge, as seems to be the case in the Netherlands. People facing end-of-life decisions may well feel subtle pressure from the medical and bioethical establishments to make the choice that will save the most money, as well as spare their relatives and society at large the burden of their continued existence."

She concludes this with "A 'good death'-- that's the English translation of the Greek word that begins with an 'e' You know, euthanasia."

The medical establishment is more aggressive than ever in pushing living wills so as to limit care--supposedly at the "end of life" but often earlier and for very nebulous reasons.

"In other words," Allen writes, "the whole point of a living will is to allow medical personnel not to resuscitate or to deny 'artificial' food, water, and breathing assistance."

If you go to NRLC's web page, you can download a Will to Live. www.nrlc.org/euthanasia/willtolive/index.html.

I would strongly advise you to do so.

Please send your comments to Dave Andrusko at daveandrusko@hotmail.com.

Part Two