In the 1970s, we had a great confidence that there
were some simple reforms that would help, says Dr. Daniel Callahan,
cofounder and president emeritus of the Hastings Center, a bioethics
research center. But the reforms havent materialized, he says.
Often no easy way to navigate between
an acceptable quality of life and a death with dignity: octogenarian had
planned for everything until a stroke put her in limbo
A 2004 survey by FindLaw, which provides online
legal information, found that 36 percent of Americans have a living
will.
Even when people have filled out living wills,
doctors often ignore them.
Good deaths are fewer than bad deaths, says Rev.
Dr. Walter Smith, clinical psychologist and CEO of HealthCare
Chaplaincy, a New York research and clinical practice organization that
combines palliative care with multifaith spiritual care.
When peoples wishes in the end are not honored,
thats a bad death.
Living wills may be asking the wrong questions,
says Dr. Terri Fried, researcher at the Veterans Affairs Connecticut
Healthcare System.
Her study in the April 4, 2002, New England
Journal of Medicine, found that when older people with serious
illness and limited life expectancy were told details of the outcomes
and consequences of treatment, 88 percent of those who would accept
lesser disabilities said they would opt out of aggressive treatment, if
it rendered them bed bound, unable to get to the bathroom alone, unable
to recognize loved ones or in need of round-the-clock help.
If you look at the language of living wills, they
say I would, or would not, want to receive X intervention, says Fried.
Better questions, she said, would probe how people want to live, or
under what conditions they would not want to live.
