Advance Directives (Living Will's)

Hello, this is my first post on this forum (sorry its so long) and at the moment I’m just after some opinions.

I’m a professional trustee in New Zealand. In my line of work part of what I do is a lot of estate planning and write a lot of Wills, Enduring Powers of Attorney etc. One aspect of my job that is starting to become more prevelant (especially since Terri Schiavo) is enquiries about directives on medical interventions. This will normally mean an Advance Directive (more commonly referred to as a Living Will). These occupy a kind of grey area in New Zealand law but under the current climate they would certainly be acted on.

I’m pretty uncomfortable with advising on these, but ultimately I’m going to be in a position where I’m asked to prepare one - in fact I’ve just noticed that our call centre has booked in an appointment for me to draw one of these up next week.

Below I’ve attached a draft copy of a Living Will. What I’m interested in is opinions on my moral responsibility with regards to taking instruction and advising on these.

Any thoughts are welcome.

Thanks

Kieran

ADVANCE DIRECTIVE

THIS IS A DECLARATION OF MY WISHES for my physician, and medical practitioner and/or hospital where I am placed, my solicitor, family and clergy.

WHEN in the opinion of my attending physician(s) there is no reasonable prospect of my recovery from physical or mental illness or impairment expected to cause me severe distress or render me incapable of rational existence (and in this regard I DECLARE that I consider a period of three (3) months to be sufficient time for such decision to be made);

OR if I have been unconscious for a preiod of two (2) months;

OR if I am in a terminal condition or in a condition of unconsciousness from which I am unlikely to recover;

**OR **if I suffer a severe stroke or other event, illness or injury accompanied by or resulting in total loss of intellectual capacity, speech or movement likely to be permanent and I no longer have the medical capacity to accept or decline life-sustaining treatment then my express instructions are as follows:

**1. SEE **that my present legal right to refuse treatments and medications is respected and that I still have the care and attention to keep me comfortable even if the approach of death is hastened.

2. DO NOT give me any treatment or employ any techniques and/or equipment designed to prolong my life.

**3. DO NOT **resuscitate me.

**4. DO NOT **give me any sustenance beyond the minimal amounts necessary to prevent my obvious distress.

5. SEE that I receive the quantity of drugs required to keep me free from pain and distress even if the approach of death is hastened.

**6. DO NOT **employ any techniques to maintain existence that is purely physical (commonly know as “vegetable existence”).

IF for any reason the physician attending me is unable to accept my instructions and to follow the declaration and wishes set out above, I respect his or her decision and fully relieve him or her from further responsibility for my care. However i request that he or she respect my wishes and take steps to transfer me to the are of a physician who can accept my instructions.

THIS DECLARATION is voluntarily made by me ##### being of sound mind and body after careful consideration and I confirm I have discussed its contents with my personal care and welfare attorney.

*Signed and witnessed etc - plus a declaration from a medical practitioner to say that the person making the Living Will is of sound mind etc *


. . . .]Below I’ve attached a draft copy of a Living Will. What I’m interested in is opinions on my moral responsibility with regards to taking instruction and advising on these.

Any thoughts are welcome.

Thanks

Kieran

ADVANCE DIRECTIVE

THIS IS A DECLARATION OF MY WISHES for my physician, and medical practitioner and/or hospital where I am placed, my solicitor, family and clergy.

WHEN in the opinion of my attending physician(s) there is no reasonable prospect of my recovery from physical or mental illness or impairment expected to cause me severe distress or render me incapable of rational existence (and in this regard I DECLARE that I consider a period of three (3) months to be sufficient time for such decision to be made);

OR if I have been unconscious for a preiod of two (2) months;

OR if I am in a terminal condition or in a condition of unconsciousness from which I am unlikely to recover;

**OR **if I suffer a severe stroke or other event, illness or injury accompanied by or resulting in total loss of intellectual capacity, speech or movement likely to be permanent and I no longer have the medical capacity to accept or decline life-sustaining treatment then my express instructions are as follows:

**1. SEE **that my present legal right to refuse treatments and medications is respected and that I still have the care and attention to keep me comfortable even if the approach of death is hastened.

2. DO NOT give me any treatment or employ any techniques and/or equipment designed to prolong my life.

**3. DO NOT **resuscitate me.

**4. DO NOT **give me any sustenance beyond the minimal amounts necessary to prevent my obvious distress.

5. SEE that I receive the quantity of drugs required to keep me free from pain and distress even if the approach of death is hastened.

**6. DO NOT **employ any techniques to maintain existence that is purely physical (commonly know as “vegetable existence”).

IF for any reason the physician attending me is unable to accept my instructions and to follow the declaration and wishes set out above, I respect his or her decision and fully relieve him or her from further responsibility for my care. However i request that he or she respect my wishes and take steps to transfer me to the are of a physician who can accept my instructions.

THIS DECLARATION is voluntarily made by me ##### being of sound mind and body after careful consideration and I confirm I have discussed its contents with my personal care and welfare attorney.

*Signed and witnessed etc - plus a declaration from a medical practitioner to say that the person making the Living Will is of sound mind etc *

I judge the above to be an immoral decree. It allows or can be construed as allowing the killing of the signer by starvation/dehydration. Withholding food and water are acts of ommission that directly kill the patient.

Euthanasia

2276 Those whose lives are diminished or weakened deserve special respect. Sick or handicapped persons should be helped to lead lives as normal as possible.

2277 Whatever its motives and means, direct euthanasia consists in putting an end to the lives of handicapped, sick, or dying persons.
It is morally unacceptable.

Thus an act or omission which, of itself or by intention, causes death in order to eliminate suffering constitutes a murder gravely contrary to the dignity of the human person and to the respect due to the living God, his Creator.
The error of judgment into which one can fall in good faith does not change the nature of this murderous act, which must always be forbidden and excluded.

2278 Discontinuing medical procedures that are burdensome, dangerous, extraordinary, or disproportionate to the expected outcome can be legitimate; it is the refusal of “over-zealous” treatment.
Here one does not will to cause death; one’s inability to impede it is merely accepted.
The decisions should be made by the patient if he is competent and able or, if not, by those legally entitled to act for the patient, whose reasonable will and legitimate interests must always be respected.

2279 Even if death is thought imminent, the ordinary care owed to a sick person cannot be legitimately interrupted.
The use of painkillers to alleviate the sufferings of the dying, even at the risk of shortening their days, can be morally in conformity with human dignity if death is not willed as either an end or a means, but only foreseen and tolerated as inevitable
Palliative care is a special form of disinterested charity.
As such it should be encouraged.

Concur, need to change it so that basic sustenance will always be provided. No matter the state of the person.

Other than that, it looks ok to me.

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