iab-728x90

The Magazine of The Evangelical Lutheran Church in America

iab-728x90

Living will

Tips offered by medical ethics experts

We read with sadness Rebecca Peterman Johnsen's account, in the February "Reader's Viewpoint" (page 57), of her family's anguish when her father's advance directives apparently were not honored.

As individuals with many years of combined experience in health care, we offer the following information with the hope that similar heartbreaking situations can be prevented:
As individuals with many years of combined experience in health care, we offer the following information with the hope that similar heartbreaking situations can be prevented:

* Ethics committees have no power to order treatment. Only doctors can give orders for treatment, such as insertion of feeding tubes.

* Doctors may not impose treatments without the patient's consent. In emergencies, absent evidence to the contrary, the patient's consent is presumed.

* If a patient is no longer capable of giving or refusing consent but 1) has a living will expressing a clear desire to reject such treatment and 2) has given a valid durable power of attorney for health care to a surrogate to act for the patient, then the surrogate has the legal right to withhold consent to the procedure/treatment. A physician who gives the treatment order and a facility that carries it out, without consent, subject themselves to legal liability.

* The right to refuse treatment is not dependent upon a comatose state nor upon a legal declaration of incompetence.

* Some treatments, such as suctioning, providing oxygen, etc., may be administered not to prolong life but to keep the patient comfortable in the final stages of dying.

Although specific factual patterns always control the ethical and legal appropriateness of a decision, the above principles generally prevail.

The living will or durable power of attorney for health care is a reflection of the thoughtful discussion of a family. Discussion should include comfort measures as well as life-sustaining treatments. In her February "Reader's Viewpoint," Johnsen is correct that just having advance directives isn't enough. One must also know how to use them.


Comments



Print subscribers and supporting Web members may comment.

Log in or Subscribe to comment.

text size:

this page: email | print

iab-728x90
October issue

OCTOBER issue:

Older adults: Assets to our church

More...