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April 12, 2005
Living Wills
If you think a living will will take care of you in a Terri Schaivo-type situation think again:
In a post a few weeks ago I wrote how James Q Wilson's research led him to conclude much the same thing.For decades, we have deluded ourselves into believing that living wills would solve our caregiving problems; that healthy individuals could provide advance instructions for what to do if they became incompetent; that such a system would ensure that no one is mistreated and that everyone defines the meaning of life
for himself until the very end. But it is now clear that living wills have failed, both practically and morally.
In the March-April 2004 issue of the Hastings Center Report, Angela Fagerlin and Carl E. Schneider survey the social science data, and their conclusions are pretty bad: Most people do not have living wills, despite a very active campaign to promote them; those who do usually provide vague and conflicting instructions; people's opinions often change from experience to experience; and people's instructions are easily influenced by how a given scenario is described. These are not problems that any reform can fix. A person simply can't grasp in the present every medical and moral nuance of his own future case.
But scholars have shown that we have greatly exaggerated the benefits of living wills. Studies by University of Michigan Professor Carl Schneider and others have shown that living wills rarely make any difference. People with them are likely to get exactly the same treatment as people without them, possibly because doctors and family members ignore the wills. And ignoring them is often the right thing to do because it is virtually impossible to write a living will that anticipates and makes decisions about all of the many, complicated, and hard to foresee illnesses you may face.
Wilson goes on to say that a living will should be backed up with a durable power of attorney. But a durable power of attorney simply transfers responsibility to another person, and it's not clear to me thatthis is a completely satisfactory solution.
Posted by Tom at April 12, 2005 11:03 AM
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