Value of the Living Will

living willsIn this issue, Dr. Rosner and Mr. Haber (see pages 441 and 442) have written about examining living wills. Both gentlemen are affiliated with Queens Hospital Center in Long Island; one is a physician and Professor of Medicine, while the other is a lawyer and Professor of Philosophy. The two approaches to living wills are remarkably different and represent a personal, searching response (Dr. Rosner) vs a pragmatic, legalistic analysis (Mr. Haber).

Dr. Rosner introduces us to living wills by informing us that medical ethics is popular in America today and our ethical vocabulary is confusing, nonspecific, and not of much help to practicing physicians who are on the firing line, trying to determine the best course of action for an individual patient. Dr. Rosner goes on to discuss the “infinite value” of human life and that only the “Divine Creator gives life and takes it away.” Mr. Haber rightfully rebuts this personal viewpoint by stating that a belief in a Divine Being “has no place in a secular society committed to formulating a rational policy for moral health care.” Mr. Haber does not make light of the sanctity of life but attempts to put into context the notion that our pluralistic society cannot be guided by one particular moral or religious set of values.

About The Living Will

Medical ethicsMedical ethics is one of the most popular subjects of discussion today. It is prominently featured in the medical literature, and several new journals are exclusively devoted to it. Numerous regional and national conferences concerned with various aspects of biomedical ethics occur with great regularity and high frequency. The press and media are also devoting major attention to this subject.

A whole new “medical ethics vocabulary” has arisen, some of which adds confusion where clarity is needed. Even the term medical ethics is difficult to define. One simplistic but concise approach is to say that the physician determines what is possible, the attorney decides what is permissible, and the ethicist suggests what is proper.

A classic example where confusion in terminology exists is the living will. Does anyone write a will when he/she is not alive? Is there a difference between a living will and a dying will? Even the English usage is incorrect. The will is not alive or dead. It is the person writing it who is living or dying.