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Comment living will

[Music] the living will is the oldest form of advanced directive it was first proposed by an Illinois attorney Louise Kutner in a law journal in 1969 Kutner drew from existing estate law by which an individual can control property affairs after death that is would no longer available to speak for himself or herself and devised the way for an individual to express his or her healthcare desires when no longer able to express current healthcare wishes because this form of will was to be used while an individual was still alive but no longer able to make decisions it was dubbed the living will in the US the patient self-determination act stuff went into effect in December 1991 and required health care providers primarily hospitals nursing homes and home health agencies to give patients information about their rights to make advance directives under state law a living will usually provides specific directives about the course of treatment that is to be followed by healthcare providers and caregivers in some cases a living will may forbid the use of various kinds of burdensome medical treatment it may also be used to express wishes about the use or foregoing of food and water if supplied via tubes or other medical devices the living will is used only if the individual has become unable to give informed consent or refusal due to incapacity a living will can be very specific or very general an example of a statement sometimes found in a living will is if I suffer an incurable irreversible illness disease or condition and my attending physician determines that my condition is terminal I direct that life-sustaining measures that would serve only to prolong my dying be withheld or discontinued more specific living wills may include information regarding an end desire for such services such as analgesia pain relief antibiotics hydration feeding and the use of ventilators or cardiopulmonary resuscitation however studies have also shown that adults are more likely to complete these documents if they are written in everyday language and less focused on technical treatments however by the late 1980s public advocacy groups became aware that many people remained unaware of advanced directives and even fewer actually completed them in part this was seen as a failure of health care providers and medical organizations to promote and support the use of these documents the public's response was to press for further legislative support the most recent result was the patient self-determination Act of 1990 which attempted to address this awareness problem by requiring healthcare institutions to better promote and support the use of advanced directives living wills proved to be very popular and by 2007 41% of Americans had completed a living will in response to public needs state legislators soon passed laws in support of living wills in virtually every state in the Union however as living wills began to be better recognized key deficits were soon discovered most living wills tended to be limited in scope and often failed to fully address presenting problems and needs further many individuals wrote out their wishes in ways that might conflict with quality medical practice ultimately it was determined that a living will alone might be insufficient to address many important health care decisions this led to the development of what some have called second-generation advance directives the health care proxy appointment or medical power of attorney living wills also reflect a moment in time and may therefore need regular updating to ensure that the correct course of action can be chosen on July 28 2009 Barack Obama became the first United States President to announce publicly that he had a living will to encourage others to do the same he told an AARP town meeting so I actually think it's a good idea to have a living will I'd encourage everybody to get one I have one michelle has one and we hope we don't have to use it for a long time but I think it's something that is sensible the announcement followed controversy surrounding proposed health care legislation that included language that would permit the payment of doctors under Medicare to counsel patients regarding living wills sometimes referred to as the infamous page 425 shortly afterwards bioethicists Jacob Apple issued a call to make living wills mandatory [Music]