An American lawyer, Louis Kutner proposed living wills in 1969 as a simple device to allow patients to say no to life-sustaining treatments they did not wish to have, even when they were too ill to communicate the fact (Kutner, 1969). Their early use revealed many problems in translating the patientsÆ wishes from the documents into specific actions for doctors to follow regarding medical treatments (Living, 2005). The advantages of living wills are: 1) they respect a patientÆs human rights and their right to refuse medical treatment; 2) they encourage discussion of end of life issues; 3) knowing what the patient wants allows doctors to make appropriate treatment decisions; and 4) they relieve the family and friends of the patient of having to make these important decisions. The disadvantages are that it is difficult to know when you are healthy how you will react in situations where a living will would take effect; it may be difficult to translate a living will into actual medical action; patients may change their minds but not their living wills; and they are of no use if they cannot be found quickly in time of need.
A living will should contain instructions for specific states such as: vegetative states, coma, brain damage which is terminal, brain damage which is not terminal, chronic and incurable disease, and serious but treatable diseases (Living, 2005). It should state which treatments are acceptable to the patient, e.g. treat everything, prolong life as long as possible, limit to less invasive and less burdensome interventions, and provide comfort care only.
The idea was originally thought up in 1967 by two groups, the Euthanasia Society of America and Euthanasia Education Council, who had been trying for years to get mercy killing bills passed in various states (Valko, 2004). They saw the living will as a new strategy of incremental approach. The Euthanasia Society of America changed its name to the Society...