British Section of the World Federation of Doctors Who Respect Human Life

from Disability Tribune

"The Hammersmith Hospital Trust is planning to ask older people to write a 'living will' which would inform doctors when to stop medical treatment should their health deteriorate' reported Disability Tribune, the magazine of Disability Awareness in Action, the international disability and human rights information network, in March 2003." However doctors intend persuading people to sign such a document by playing on people's negative assumptions about impairment. People will be asked to imagine their life if they had cancer, advanced dementia, were doubly incontinent or 'confined' to a wheelchair.

"What is alarming is that yet again the medical profession have deemed themselves 'the experts' in deciding what is an acceptable or unacceptable quality of life. Indeed the doctors will almost certainly fail to mention what support statutory agencies can make available should the individual decide to ignore the 'living will' option.

"The decision to introduce this policy was taken after a survey, funded by the hospital trust, showed that older people would rather not have their lives prolonged by medical treatment if they were terminally ill. Instead they would rather be 'kept warm, comfortable and free from pain.' However, the reality of ceasing medical treatment, which since a recent court decision includes food and water, can mean a slow and painful death."

The Medical Ethics Alliance commented on this leading hospital's pilot scheme:

"Patients should beware of the implications of what they sign up to, as one effect of signing as the [Sunday Telegraph] article correctly explains, is to put yourself into the hands of those who may interpret the piece of paper in a way you had not expected. What is more, your relatives may not be able to help you."

Nurse Nancy Valko, a campaigner against euthanasia in the U.S.A., writes in connection with a court case there (13 March):

"I've often asked my patients who have made out such directives what it is they want and I've never had a patient who really understood what he or she had signed. Instead, they believed the hype that such directives would protect their rights and spare their families suffering. "I believe that such directives are also a kind of anti-informed consent document because the person is asked to make a legally binding decision before a particular situation arises and without an explanation of legal terms or the risks/benefits of particular treatments. For example, the term 'artificial nutrition and hydration' has even been interpreted to include a simple IV!"