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,
nothwithstanding 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.
This Divorce Store® Living Will Kit includes living will forms for each of
the 50 United States, plus, medical powers of attorney drafted in
accordance with the laws of each state , which may be differently titled,
but nevertheless, provide all of the benefits accorded under state laws.