[UPSTATENYRN]

Often at the hospital where I work (on Geriatrics/Nursing Home Care Unit) our residents/pts have signed Living Wills detailing their wishes for DNRs, DNIs and feeding tubes, etc; then ,when the time comes, their wishes are over-ridden by the demands of family members when these pts can no longer stand up for themselves. Even when presented to the Ethics board, very often the family members prevail and it saddens us to be forced to pour cans of whatever into tubes knowing the patient specifically didn't want that. Often the family members never even visit, just collect the checks. It seems maybe the hospital is afraid of the families suing-who knows? I know this has probably been discussed on these boards a zillion times, but I'm relatively new to this great knowledge/opinion forum (which is very informative), so I'd like some opinions and experiences on how you have handled this issue in the past...

[Annaiya]

The answer to this is going to vary based on the laws of each state. It looks like you're in NY, so these might help explain it better for you.

www.oag.state.ny.us/health/EOLGUIDE012605.pdf

http://www.nysba.org/Content/NavigationMenu/Public_Resources/Programs_and_Resources/Educational_Pamphlets/livingwills.pdf

If there isn't state law dictating the enforcement of the living wills, then it is entirely up to the judge to decide. Since most judges aren't going to like feeling responsible for ending someone's life and causing the family to suffer from it, they are going to side with the family more often than not. I saw something saying that NY doesn't have any laws governing this, and that could be why things are like you describe. The only way to change that is to lobby the legislature.

I agree it is sad when the families won't follow the person's wishes, especially when the person cared enough to create a living will.

[Tweety]

Here in Florida families can override living wills, which amazes me. It is indeed sad.

I think often family members get confused as to whether the patient is in a "terminal condition" or not. Sometimes the family member is relatively aleter, tracks with the eyes, etc. and the family would think that not feeding them would be starvation (remember how many people supported keeping Terry Shavio alive).

But family members that opt for futile care against the wishes of their "loved" one just to collect a check disgust me.

[miracle1986]

I was in a situation when an elderly woman was dying right before me. The son ran in and withdrew her living will. My supervisor informed me to send her out (to hospital). I found out later that he had every right to do so. So, basically, living wills can be superceeded.

[MarySunshine]

Yeah, the only thing they're good for is when the family actually CARES what the person would want and so they refer to the will. It helps them to not feel any guilt if the person's wishes lean towards withdrawing care.

[ZASHAGALKA]

Not to detract from the thread, but Tweety mentioned it. I was NOT in favor of keeping Terry Schiavo alive, but I was decidedly AGAINST her ex-husband being her NOK to make the decision. And, since he had a de facto common law wife, he WAS her 'ex' for such purposes. In fact, he did not begin to advocate FOR terminating her treatments UNTIL he was in a living arrangement with his new 'wife'. Since he could not officially marry his new woman until Terry was dead, this, to me, represented a complete conflict of interest. The GOLD standard for surrogate decision-making is what the patient would want, not what the new wife wants.

How many of YOU would want YOUR ex-spouse making such decisions for you?

In any case, moving on: yes, it seems that MOST living wills are conveniently subject to being changed by those that are left to sue. And, as has been pointed out, in ANY dispute, those that argue in favor of keeping someone alive instead of allowing them to die will likely win, Terry notwithstanding. Ours is a society inherently afraid of dying. That dynamic certainly plays to how we arbitrate such decisions.

The upshot is that a living will is simply not enough. You MUST make those that can challenge your will well aware of your desires, as well.

That's just a by-product of our highly litigious society that fears death. The law can only go so far to compensate for our individual motivations.

~faith,
Timothy.