Today, 80-85% of Americans die in medical institutions. Of those, 70% require decisions about whether to apply, withhold, or withdraw medical treatment (Makar 58). Due to this ever increasing number, the right to die is one of the most popular and controversial topics in medicine today. The issue comes down to personal beliefs and ethics and the fact that there is so little clear-cut legislation on this topic confuses it even more. Advance Directives provide, in theory, for self-determination and put the patients mind at ease with the knowledge that they have decided for themselves the extent of health care that they wish to receive. Also, for the family, the process of watching their loved one suffer through unwanted medical treatment is eliminated. In practice, however, there are a lot of inconsistencies and legal barriers that place limits on their usefulness.
Some would argue that there is a limit to the amount of self-determination a patient retains even with an advance directive. They would say that a part of self-determination is that the patient makes an active, mental decision about his/her health care, and that advance directives dont fulfill this requirement. Regardless, it is clear that it is better than having no voice whatsoever in the decision. Also, in regard to attitudes toward self-determination today, many people waive this right either because they dont know that they have a choice or because they feel that they dont have a right to question a doctor or make medical decisions themselves (report Abram et al. 49-50).
Alan Lieberson, author of the Living Will Handbook, describes a progression that our society has taken that has led to the necessity of ad...
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---. Making Health Care Decisions (Report) Washington D.C.: U.S. Government Printing
Alexander Law Firm. Medicare and Advance Directives. U.S.. Government Printing Office, 1993. Available: http:/www.seamless.com/alexanderlaw.
Arnitage, Matt. Opus Communications Health Wave. 1996. Available:http://www.opuscomm.com/nls/samples/balsample.html.
Lieberson, Alan D. The Living Will Handbook: The right to decide your own fate. Mamaroneck, New York: Hastings House, 1992.
Makar, Marjorie Conner, BSN. Consent and Right to Die. CME Resource Sacramento, CA: 1994.
Peer Review Systems. Health Care Quality Improvement Program Advance Directives Final Report. December 1995. Available http://cme-1.med.ohio-state.edu/prs/adv-fnl.htm.
Right to Life of Michigan. Living Wills and Durable Power of Attorney. Available:http://www.rtl.org/lwpda.htm.
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