Living Wills A Good Idea, As Long As . . .

Having and end-of-life plan is a good idea, as this article points out. However, when it's tied to cost-cutting, we need to be careful that living wills are not forced upon people as a way of tying living wills to cost effectiveness.

Advance Directives Might Curb Cost of End-of-Life Care

Depending on where you live, having an advance directive may raise the odds that you'll receive hospice services and reduce the overall cost of your end-of-life care, a new study indicates.

An advance directive, sometimes called a living will, is a legal document that expresses your wishes for the type of care you would like to receive should you become unable to make such decisions yourself. more

Idaho Tries To Make Sure Living Wills Are Honored

This is what we’ve come to, folks – in Idaho, they’re trying to get a bill introduced that will ensure that advance directives are honored by doctors. Aren’t we lucky to live in such screwed-up times?

Loertscher mulls killing bill to protect dying patients’ wishes in living wills

House State Affairs Committee Chairman Tom Loertscher, R-Iona, says he hasn't decided whether or not to allow a hearing on legislation from Rep. Leon Smith, R-Twin Falls, to amend Idaho's “conscience law” to ensure that patients' living wills and advanced care directives are followed - but he's  leaning against it. “I'm prone not to,” Loertscher told Eye on Boise. “It's only been in effect for six months or less. Let's see how it goes for a while.” more

Remember: No Matter What The Law, Some Doctors Will Do Exactly As THEY Please, Patients Be Damned

I have written often about the concept I call Doctor Power. That is, that physicians are accorded, and use, immense power in dealing with their patients and their families. Most people assume that this is power used for the good of the patient. Uh-huh. You better think again. Here’s another example: A Canadian patient who has stated in no uncertain terms that he wants all measures taken to keep him alive, no matter the severity of any side effects. Guess what? The doctors are saying baloney – THEY have the power to refuse treatment because THEY say so. The hell with the patient's and the family's wishes. Better chat to YOUR doctor and see how they feel about respecting your (legal) wishes . . .

Family, doctors battle over ‘do not resuscitate’ order

Mann Kee Li, shown with his two sons and nephews, is currently in and out of consciousness and unaware that his wish for life-saving care is being denied, his family says.

As Mann Kee Li lies in hospital fighting dire prospects, his family is engaged in a life-or-death struggle, not with the cancer spreading through his body, but with the doctors treating it.

Li, a 46-year-old Toronto accountant and father of two young boys, wants doctors to use all medical measures possible to save him in the event of a life-threatening emergency.

He made those intentions clear to his doctors at Sunnybrook Health Sciences Centre when he entered the hospital in August. He wrote it in a power of attorney document and confirmed it in a videotape statement, his lawyers say.

While his doctor initially agreed to respect those wishes, physicians unilaterally reversed the decision a week ago without consultation and imposed a “do not resuscitate” order, his family alleges. more

The Need For Discussing Living Wills Carefully

First of all, having and advanced directive (living will) is probably better than not having one. However, they are often carelessly written, and there is quite strong evidence that patients are not fully informed about what they are and what the mean. It’s particularly important that it’s not simply a “Do you want to live or die when you are in dire medical circumstances?”

Living wills' lack of specifics limits their usefulness

Patients often opt for more end-of-life care when given detailed circumstances -- at odds with responses to a general question, a new study says.

Living wills fail to capture patients' end-of-life care wishes because they do not ask about the real-life scenarios patients are likely to face as they

get close to death, according to a new study. Researchers from Thomas Jefferson University in Pennsylvania examined interview responses of 202 Philadelphia-area patients age 70 and older

for the study in the May 22 Journal of Palliative Medicine.

Patients first were asked a question used in many Pennsylvania living wills, probing whether to "withdraw life-sustaining treatment that serves only to prolong the process of dying." Patients then were queried about their desires about more specific scenarios, such as whether to use antibiotics to treat their pneumonia if they also have Alzheimer's disease. There was a 23% average correlation between the responses.

"This study points out that if you talk to people in more detail, there's more nuance to their decisions than just results from a simple question about what they want in a living will document," said Charles F. von Gunten, MD, PhD, editor-in-chief of the Journal of Palliative Medicine and provost of the Institute for Palliative Medicine at San Diego Hospice. more