Bringing Balance to Hospitals-

The Patient Self-Determination Act and the Will to Live

Grassroots pro-life activists should waste no time in contacting local hospitals and nursing homes to inform them about the Will to Live, and to encourage them to make copies of it available to their patients. At present, many health care facilities are promoting living wills and other documents slanted toward rejection of treatment and even food and water.

Hospitals became directly involved in providing advance directives to entering patients as a result of the federal "Patient Self-Determination Act," which went into effect on December 1, 1991. It requires hospitals, nursing homes, and certain other health care providers for Medicare recipients to implement institutional policies concerning "advance directives." These policies must provide for routinely informing patients upon admission about their state's law - - whether established by the legislature or the courts - - regarding advance directives concerning medical treatment should the patient become incompetent, such as living wills and durable powers of attorney for health care. The institution must then document in the patient's medical record whether or not he or she has signed such a document. Each health care provider must also provide education for staff members and the "community" about advance directives.

Groups sympathetic to denial of treatment, food and fluids have been very effective in interacting with health care facilities to help them develop their plans for complying with the Patient Self-Determination Act. The result is a distinct slant in the way the options are presented in many, if not most, institutions.

Now, the availability of the Will to Live provides us with an opportunity to argue for a more balanced approach. Pointing out that the act refers to the "right to accept" as well as to "refuse" medical treatment, we can make a strong case that these institutions ought at least to offer the Will to Live as an alternative. At a minimum, they ought to include the appropriate state version in the packets of sample advance directives often already being given to patients upon admission. Educational materials and presentations by health care facilities should give equal prominence to the patient's option to sign the advance directive that creates a general presumption for life, the Will to Live.