I’ve always been uneasy with the concept of the “living will,” known in technical terms as an advance health care directive. Part of my uneasiness stems from the fact that I do not know at this moment, in this situation, what I would want to be done in a potential situation where my life circumstances may be dramatically different. I would not want an unknown medical professional, who practices an ethic unbeknownst to me, to interpret what I was thinking when I wrote the living will.
Today’s Washington Post has a facsinating op/ed by Charlotte F. Allen which raises some similar points:
According to [a 2004 Hastings Center Report], it seems that people talk a good game about living wills, especially when they’re healthy, but when their health begins to fail, they often have very different ideas about what they would be willing to undergo to stave off death for a little while. Furthermore, according to a 1990s study by the National Institutes of Health, even when patients have living wills, if those wills contain directives with which doctors and hospitals disagree (such as, I myself suspect, prolonging the patient’s life instead of terminating it), many doctors simply ignore the patient’s desires. Living wills, it would seem, are effective only if they happen to comport with doctors’ and bioethicists’ own theories about what is best for the patient anyway. For this reason, the authors of the Hastings study propose that instead of filling out a living will, people execute a durable power of attorney, a simple document that entrusts decisions about end-of-life care to a relative or friend who shares the signer’s moral beliefs about death and dying. That sounds about right to me.
Far too many Americans have bought into the notion that a nebulous characteristic called “quality of life” should be the determining factor in whether we should live or die. When doctors become the arbiters of our destiny, the outcome is likewise murky. A doctor who is a proponent of the “right to die” movement, for example, might interpret your case differently than one who found euthanasia morally repugnant.
The so-called “right to die,” is of course, one of those meaningless terms which are deployed only for political expediency. After all, if death is a “right,” then it is certainly a right of which none of us will be deprived. Death is much too easily obtained to be considered a commodity denied to a certain group. But “rights” language is politically charged, and therefore gets the issue of euthanasia on the table. The problem is that this issue is already on far too many tables in America’s medical community.
The other question that a living will does not answer is this: do our own wills carry the authority to decide whether we should live or die in any given circumstance? Legally this may be the case, but theologically speaking, there is only one who gives and takes life.