Advance directives, or “living wills” as they are commonly called, attempt to permit individuals to have a voice in situations where they are otherwise unable to control what is done to them.
When they first appeared, they simply tried to prevent over-treatment at the end of life, and counter the over-zealousness of doctors who refused to recognise when “enough was enough”. Nowadays, although still serving this purpose and with the support of the law, they are increasingly being used to guide doctors in selecting treatments and non-treatments in accordance with the patient’s values.
Living wills are legally persuasive if they are validly executed and applicable in the circumstances that arise. The difficulty of prosecuting doctors who ignore them remains outstanding as the incapacitated patient is in no position to begin a lawsuit.
Exit’s research on living wills is widely respected. From legal texts such as in Finance & Law for the Older Client, academic texts such as in Contemporary Issues in Law, Medicine and Ethics, the world-first publication of Collected Living Wills, to setting up the Living Wills & Values History Project and helping persuade those behind legislation of the need to incorporate values statements in the statutory provisions.
Exit’s L:ving Will Pack comprises three separate documents. The first is a starter living will, which has been widely adopted by other societies. Completing an effective living will is partly about having a good starter document and partly about the degree of foresight and effort the patient feels is appropriate to put in at any particular time. For those who want a far-ranging document that will apply in as many circumstances as possible, Exit also provides a more detailed, 4-page living will. Finally there are many other wishes that cannot be made legally binding but which are both effective for guiding doctors and for explaining one’s wishes to friends, family and officials. Persuasion can, in some situations, work better than force. For this reason Exit also encourages people to use the Values History Statement.
The updated living will pack is mostly an updating of minor details. There is no need for existing members to acquire new documents – in fact re-affirming any existing ones (with date & signature in the margin) shows the document represents your persistent and enduring wishes. A living will pack is provided at a cost of thirty pounds or has always been included free of charge in the new member’s joining pack. Existing members requiring a complete new set of documents may apply at the reduced price of £15 and a large (C4) stamped addressed envelope.
