WA On-Line access to Living will...

Like a hand-full of other states, WA has gone on-line with documents to help verify health care wishes for residents of Washington.

This site includes AA, DPOA, POLST and Mental health directives. Patients and physicians are asked to fax or mail in copies of these forms to the department of health. Then an account is set up for the patient to access their own information on-line.

If a health care provider wants to gain access to the information they must apply for an account through DOH and must have a valid license.

A Few More Resources

These are all from the UW Ethics in Medicine site. Click on the Bioethics Topics button to see the long list. Relevant to this week are:

Advance Directives
Do Not Resuscitate Orders
DNR During Anesthesia and Urgent Procedures
End-of-Life Issues
Physician-Assisted Suicide
Termination of Life-Sustaining Treatment

These pages provide excellent information about both medical and ethical issues related to DNR and end-of-life situations.

Why Do Doctors Ignore Living Wills?

In the reading for today, the author cites a survey which concluded that 65% of physicians "would not follow a living will if the instructions conflicted with the doctor's own view of the prognosis or expected quality of life." (Colby p. 142) My first reaction to this statement is: Who do those doctors think they are, substituting their judgement for my wishes!!!

But then I begin to wonder how this situation arises. The living will seemingly can only "respond" to specific scenarios. Who is defining that scenario that the living will is responding to? Who beyond the physician is outlining the prognosis or expected quality of life? Who is the doctor disagreeing with? Is this statistic saying that physicians substitute their judgement if they think the patient didn't really mean what they said in their living will or that they would feel differently about their life (say as a quadraplegic) if only they had a chance to live that life?

Other thoughts about what this statistic is really indicating?