Living Will legislation goes by many names. It may be called "Death With Dignity," "Rights of the Terminally Ill," or "Patient's Rights" legislation. All of these names emphasise understanding and compassion. The Living Will is defined by pro-euthanasia groups as a document by which a person can assert, in writing, a desire not to be kept alive by life-sustaining medical equipment and procedures when his or her condition has been diagnosed as terminal, or under certain other well-defined conditions.
Most Living Wills signed in the US or Holland today are form-type wills, but, as with any legal document, they can be custom-tailored to meet any actual or perceived need or wish, including;
Requesting or refusing artificial feeding tubes, antibiotics, dialysis, respirators, cardiopulmonary resuscitation, and other specified treatments
Requesting pain medication
Stating the desired place of death, including at home
Designating a proxy to make health care decisions when the individual is incapable of doing so; and
Requesting designation as an organ donor
Most Living Will proposals have been written and promoted by organisations which support and campaign for euthanasia. They include:
The Society for the Right to Die
Americans Against Human Suffering
Concern for Dying
Hemlock Society, which lobbies for direct euthanasia, and which publishes a "how-to" manual on suicide
In fact, the original concept of the Living Will originated with these pro-euthanasia groups. The Living Will is seen as a publicly-acceptable way to introduce the agenda of legalised active euthanasia, suicide, and assisted suicide.
The primary danger of the Living Will lies in the fact that it is usually signed long before the person knows when he or she will be incapacitated, or what the circumstances of that incapacitation will be. This means that the specific treatment (or lack thereof) for the future condition cannot be specified.
Presumably, one can revoke a Living Will at any time by making a verbal or written statement to a physician, nurse, or other health worker.
This, of course, is contingent upon the individual's condition at the time he wishes to change his mind. If he should experience a change of heart after he is incapable of communicating, he is out of luck. Also, if the presiding health care professional feels that the patient's wishes are the result of trauma or some other cause, they can be totally disregarded.
If a Living Will has been signed, it is probably legally binding under the current conditions in the judicial system. It would therefore be difficult or impossible for a family doctor to make the decisions which could be in the patient's best interests.
This set of conditions makes it virtually impossible for the signer of a Living Will to define precisely that treatment that he wants, or does not want.
A person may feel justified and secure in signing a Living Will, but, even if the document were medically and legally secure in every way at the time of its signing, there is no way of knowing how the definitions and rules will change as the pro-euthanasia groups lobby and push for more favorable (for them) conditions.
Take as an example the most common "form" Living Will, which has been signed by millions;
"If I am permanently unconscious or there is no reasonable expectation of my recovery from a seriously incapacitating or lethal illness or condition, I do not wish to be kept alive by artificial means."
Ten years ago, "artificial means" would have meant truly extraordinary or "heroic" medical or surgical procedures. Now, in some states in the USA, and in other countries around the world, respirators, codes, kidney dialysis, and even food and water are defined as "artificial!" In other words, a person might sign a Living Will in a state where food and water are standard treatment, and then travel to a state where they are defined as "extraordinary treatment," and become incapacitated. Or else, the courts or legislator in his home state may quietly define food and water as "extraordinary treatment," and he will not be aware of the fact. What happens then?
If Living Wills become popular, their existence will vastly complicate hospital decision making. How would a doctor treat a patient who has not signed a Living Will? Would he expend every effort possible to save the patient? Or no effort at all, in the belief that the person wanted no treatment whatever? If a significant percentage of the population had signed Living Wills, would it be assumed that every possible effort should be expended to save all emergency room patients? How can the physician be certain that a person has or has not signed a Living Will?
Perhaps uppermost in the physician's mind is the fact that failure to comply with a legally binding Living Will would make him liable for damages. What would he do if confronted with an emergency situation where the status of the patient's Living Will were unknown? Would he proceed with treatment that might be against the patient's wishes? What would he do if the Living Will specified some action or lack of action that conflicted with his religious beliefs, or with hospital regulations?
1. The Living Will is unnecessary because everyone already has the right to make informed consent decisions about their own medical treatment.
2. The Living Will is unnecessary because doctors are already free to withhold or withdraw useless procedures that provide no comfort or profit to terminal patients.
3. The Living Will is unworkable because it is theoretically impossible to make well-informed and logical decisions regarding health care before illness or accidents happen. Nobody even knows how they will react if they are incapacitated.
4. Living Will language appears to be precise, but in reality it is extremely vague, and can be interpreted in an almost unlimited number of ways, many contrary to the actual intent of the signer.
5. The Living Will is counterproductive because doctors are currently protected from malpractice suits to a certain degree when dealing with terminal cases. However, the addition of a relatively random legal element such as the Living Will greatly increases the possibility of malpractice claims by surviving relatives due to the extremely vague language of the Living Will. Physicians are in the midst of an acute malpractice crisis. A doctor may take the safest course of action for himself and withhold treatment that would preserve the life of the patient in cases where there is some question brought on by the vagueness of the Living Will language. In other words, dead patients don't sue!
6. The Living Will is counterproductive because it may restrict physicians and relatives from making health care decisions that are truly in the best interests of the incapacitated signer.
7. The definitions contained in a Living Will are constantly changing. For example, the term "heroic treatment" may soon evolve to include food and water. Therefore, a person signing a Living Will now may have unintentionally signed his own death warrant by starvation and thirst if he does not carefully keep up with legislation in the area of health care decisions. And it is a safe bet to say that 99 percent of Living Will signers do not do this.
8. Legally binding fill-in-the-blank Living Wills do not make age distinctions. A person who might refuse a certain life-sustaining measure if he were dying of brain cancer at age 85 may not refuse the same treatment if he were the victim of a car accident at age 25. The Living Will makes no distinctions in this matter.
9. The Living Will is dangerous because it does not completely define the complex term "competency." Therefore, a person who decides to contradict one or more of the specifications in his own Living Will might be refused because he is ruled technically "incompetent."
10. The Living Will is dangerous because there is a heavy push on for cost containment and socialised or nationalised health care. The widespread use of Living Wills will insure that the balance tips towards undertreating patients, which has killed a thousand times as many people as overtreating them.