With the development in America of the support for involuntary euthanasia, sick and disabled Americans do not have legal protection from being killed. We cannot count on a general respect for life to protect patients, or leave matters to be worked out informally among doctors, patients and their families. The hard reality is that the presumption has now shifted to favor death, not life.
What can we do to protect ourselves and our families from this frightening situation? We need to have an advanced directive and a Will to Live to protect us. A Will to Live is a legal document that names someone to make health care decisions for us and provides clear, written instructions explaining that we wish to be given health care if we are incompetent to direct our own medical care. While this cannot guarantee that we would be protected from all court challenges to our life, it certainly provides a legal document that can stand up to such challenges. In addition, it provides our families with a tool to assist them in directing our medical care.
It is important to understand that there is a difference between a statement of principle and a legal document. A legal document provides specific directions, as defined by law that can guide specific actions. It helps to look at this from a perspective that concerns all of us. We can agree on the principle that an employee should receive a “just wage.” We can agree with our employer that we ought to be paid a “just wage.” However, none of us would agree to an employment contract that simply stated we would receive a “just wage.” We expect the contract to provide a specific amount.
Similarly, with an advanced directive, it is not enough to say that we want to receive “ordinary medical care.” We need to specify exactly what we want in terms that have specific legal power to protect us. The Will to Live provides a document that begins with the presumption for life. It calls on the medical establishment to provide medical care, unless the patient wishes to request special conditions related to individual medical needs, which are outlined in the document.
One would not be protected by one widely used “Living Will Declaration,” which states, “If I should be in an incurable or irreversible mental or physical condition with no reasonable expectation of recovery, I direct my attending physician to withhold or withdraw treatment that merely prolongs my dying.” This is broad indeed. If you walk with a limp or develop some irretrievable memory loss, you may well have an “incurable condition.” If either of these happens to you, and, having signed the “Living Will Declaration,” you become unable to speak for yourself, that means you will be deprived of all medical treatment and food and water (possibly including what you could be spoon fed).
The term “merely prolongs my dying” may sound as though it limits this, but it really doesn’t. No time frame is given, and the truth is that we are all “dying.” Literally every life-saving medical treatment “prolongs dying,” in the legal sense.
The bottom line is this: If you are someone who doesn’t want medical technology to prolong your last hours, but who also doesn’t want to be starved or allowed to die just because you have a disability, your wishes will be far more likely to be respected if you sign a properly prepared Will to Live than if you sign a so-called Living Will.