The Alpha National Living Will Kit
By Kermit Burton, Alpha Publications
The complete do-it-yourself Living Will Kit with easily prepared
Living Will Declarations and Medical Powers of Attorney for
each of the 50 States which are drafted in accordance with the
Laws of each such State.
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Description:One of the more notable modern day medical achievements is
the ability of medical practitioners to employ a variety of
available medical procedures to keep medically alive an individual
who may otherwise be considered brain dead.
In a broader, rather than a narrow description of these medical
procedures, it is generally perceived that life support procedures
include any or all of the following procedures, namely: cardiopulmonary
resuscitation, mechanical respiration, artificial feeding, kidney
dialysis, chemotherapy, transfusions of blood or blood components,
antibiotics, pain medications, etc.
It can however be noted that most of these procedures can
appropriately be classified as lifesaving rather than life supporting
in the sense that life can be continued or restored when any
one or more of these medical procedures are employed.
But, the real concern is whether or not the use of any of
these procedures is professionally ethical when an individual
is in a permanent or persistent vegetative state which has been
deemed irreversible.
The problem lies not in the ability of medical practitioners
to keep an otherwise brain dead individual alive, but in their
ability to correctly diagnose the vegetative state of an individual.
In other words, medical technology has not achieved a fool
proof standard that can unequivocally diagnose whether or not
an individual is permanently unconscious.
This then is precisely why the Right-to-Die Laws differ among
the various states. For example, some of the State Law Makers
were not convinced that the decision to terminate any Life Support
Systems should be left to other than the discretion of the medical
practitioners or hospital staff.
Fortunately, many others were convinced that the decision
to terminate Life Support Systems could be entrusted to the
affected individual in the form of an Advance Directive which
commonly became known as the Living Will Declaration.
Many of these law makers were besieged with countless stories
of families who had experienced a severe financial crisis when
a medical institution continued to employ expensive Life Support
Procedures over the objections of the patients' family and,
in many cases, the attending doctor.
In 1990, one of the widely publicized cases in this area
was the Nancy Cruzon Case, which originated in the State of
Kansas and went before the United States Supreme Court. The
Supreme Court, while not granting the relief sought on behalf
of Nancy Cruzon to terminate the life support systems, did recognize
the right of an individual to make a Living Will Declaration
or other similar document that authorizes the termination of
life support systems.
Since Nancy Cruzon did not have a written document expressing
her desire not to be kept alive with artificial life support
systems, the Supreme Court did not order the termination of
the life support systems.
The United States Supreme Court also gave the States wide
latitude in prescribing the legal provisions and requirements
for making a Living Will Declaration or similar document.
In 1991, the United States Congress enacted a law called
'The Patients Self-Determination Act.' The law effectively requires
that any hospital, nursing home or other health care facility
participating in the Medicare and Medicaid Program must inform
all adult patients of their right to make a living will under
State Laws.
While the Living Will Declaration purports to be a declaration
by the maker to terminate life support procedures, in some cases
however, it also addresses what life support procedures can
be continued, plus, if State Laws so provides, it allows for
the termination or continuation of intravenous feeding.
In other words, those States that do prohibit the termination
of food and fluids have concluded that even when considering
the vegetative state of an individual, it would not be appropriate
to starve the person to death by withholding food and fluids.
This issue gained national prominence in 1992 when a woman
in a New York hospital unexpectedly awoke from an extended coma
in an otherwise healthy condition. However, considering the
extended period of the coma, had food and fluids been terminated,
it is highly unlikely she would have awoken since she would
have no doubt starved to death.
The point being made here is that serious consideration should
be given to any decision that allows the withdrawal of food
and fluids, not withstanding such rights under State Laws.
Also, it was recognized by many State Law Makers that the
terminal condition of an individual was not the only consideration,
but also consideration of the non-terminal unconscious condition
of a person. Therefore, it was this consideration which resulted
in the enactment of Health Care Appointment Laws that provides
a person the right to appoint another to act on his or her behalf
in the making of medical treatment decisions when such person
is unable to do so himself or herself.
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