Living wills don't work, ...( ANN ARBOR Mich. Living wills don't wo...),Health

The failure of the living will is highlighted in an article that will be published this week in the new issue of the bioethics journal the Hastings Center Report by a U-M internal medicine researcher and a professor of law and internal medicine.

What they find is provocative: The documents designed to help people choose the treatments they would like when dying fail to meet five key criteria for success. Worse, the evidence suggests they don't work. They base their conclusions on a comprehensive review of hundreds of studies of living wills, end-of-life decisions and the psychology of making choices.

The authors are taking on a document that has become ingrained in American medical culture, that the law of almost every state specifically recognizes, and that hospitals are required by federal law to tell their patients about. It is a document that many experts recommend to avoid the kind of problems raised by the Terry Schiavo case in Florida, a case in which a patient's husband and parents have fought a long legal battle over whether she should be kept alive.

The U-M team can imagine circumstances where the living wills may be useful for patients who are imminently facing death, who know their medical circumstances and who have strong and specific beliefs about them. But the researchers conclude that living wills offer a false promise of control over end-of-life treatment.

The best patients can do, the researchers argue, is to use a "durable power of attorney" to appoint someone to make decisions for them when they can no longer make their own decisions.

"Our review shows that the evidence about living wills demonstrates that they fail all five tests that would have
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Contact: Kara Gavin
kegavin@umich.edu
734-764-2220
University of Michigan Health System
10-May-2004