For Immediate Release:
LivingWillsAndPVS.html


Living Wills: Unexpected Weaknesses

Editor, Legal scholar, and Biology/Chemical Science Honors Major, Gordon Watts, of Lakeland, Florida, dispels some myths about the strength of "living wills." They have historically failed to protect people from various abuses. The diagnosis of "PVS" is also historically fails in almost 50% of the cases, as does any diagnosis attempting to divine or discern the "wishes" of a patient.

LAKELAND, FL (The Register) Monday, 11 April 2005 - these excerpts, with sources cited, tell the tale and document the wild claims now made about living wills and other things:


* Notes by Attorney Matt Conigliaro on Living Wills:

“Let's go back to an issue I raised the other day but unfortunately could not follow up on until now. How binding is a living will? Or any other written form of someone's wishes? I've been disappointed to hear a number of public figures speak of living wills as being sacrosanct, and I have heard one high profile nighttime television host state numerous times that, unlike Terri's wishes, his wishes are in writing and there will never be an issue for him. Softly put, that's a reasonable expectation, but the host hammered the point repeatedly, saying his written statements were beyond assail.

That's not true, at least in Florida. It may not be easy to overcome a living will, but it can be done by clear and convincing proof that the person subsequently made contrary oral statements.”

http://abstractappeal.com/archives/2005_04_01_abstractappeal_archive.html#111239565871488570

* State Laws on Living wills:

765.304(2)(c) Procedure for living will.-- Before proceeding in accordance with the principal's living will, it must be determined that: Any limitations or conditions expressed orally or in a written declaration have been carefully considered and satisfied.

http://flsenate.gov/Statutes/index.cfm?App_mode=Display_Statute&Search_String=&URL=Ch0765/SEC304.HTM&Title=->2004->Ch0765->Section%20304#0765.304

* Notes by The Register on living wills:

Abstract Appeal dot com blogger and Attorney, Matt Conigliaro, often vilified by the “save Terri” crowd, is technically correct here, but he, in my opinion, vastly understates the situation:

MANY people have had living wills -which have been flat ignored -or worse, used as an excuse to give substandard care and/or attempt a premeditated murder, under the guise of “it was her wishes.” See, e.g., the following:

* Marjorie Nighbert’s Living Will:

“Marjorie Nighbert signed an “advance directive” before she was hospitalized for a stroke in 1996. This document stated that she desired no “heroic measures” Based on this, her family requested that her feeding tube be removed. When Ms. Nighbert begged for food, the courts deemed her 'not medically competent to ask for such a treatment,' and the hospital physically restrained her in bed so that she could not pilfer food from other patients. She died ten days later.” [Note: This citation from the Catholic Culture website was verified as correct from numerous independent sources, not the least of which is Focus on the Family.] http://www.CatholicCulture.org/docs/doc_view.cfm?recnum=5524

* Gary Amos’ Mother-in-Law’s Living Will:

Living Wills

The problem is that doctors and nurses don't read them. It does not matter how carefully a lawyer may word a living will. It does not matter where the living will draws the line about when you want to be treated and when you don't want to be treated. What the document says is irrelevant.

Go to any critical care center and you will see handwritten signs by magic marker taped on the door or near the patient saying "Living Will." So on a sheet of typing paper there will only be two words "Living Will." It says nothing else.

Those two words are short hand to the medical personnel that: "This person does not want to live. If there is any downturn in the condition let him (or her) die." So, for example if there is a heart attack, don't use CPR.

People and their lawyers think that a living will tells the medical community that you don't want to be kept on a respirator or other expensive lifesustaining emergency and critical care equipment if your organs are shutting down from cancer or some such, or if you are becoming brain dead.

But people do not know that having a living will and telling the doctors and nurses about it means that they have just given the medical community the green light to provide substandard care and to pay only minimal attention to the patient because this patient wants to die.

Here is an example. My mother in law had a living will that said if her cancer got to a certain point where she had to be kept alive by being put on life support she did not want to be put on life support. Well the chemo worked and she began recovering from cancer. However, while in the hospital recovering she had a heart attack. Thankfully, her daughter and [sic] daugher in law, both registered nurses and both experienced in [sic] trama care, happened to be in the room when the heart attack started. They hit the emergency button to call for help. The RN daughter jumped up on the bed, straddled mom's body, and began doing CPR until she was revived.

When the medical personnel did not show up to help and had to be brought by personal request, they said "oh, she had a living will. She did not want to have help if she had a heart attack." They were not going to do anything about her heart attack, even though the heart attack was not part of the living will. The living will was about being not being kept indefinitely on life support if the cancer went too far. The doctors and nurses took the two words "living will" to mean, "let her die if she has a heart attack, a stroke, or any other life threatening emergency besides the cancer." Good thing she didn't choke on a piece of chicken while the nurses were around.

Letting her die in the event of heart attack was not at all what her living will said. But the medical personnel did not read it. They don't read them. All these living wills are worded somewhat differently, but it doesn't really matter. A lawyer can spend hours drafting a carefully worded living will. It's a waste of time, because only two words count -- living will. And they take this to mean, "let them die."

To the doctors and nurses, the words living will means that we can ignore this patient no matter what happens.

So now we have this great push for living wills. People are being led to think that living wills and advance medical directives are really great. They may be, but don't tell your doctor or nurses that you have one until after the crisis is clearly underway. Otherwise you won't get the care you should have been getting even if you didn't have a living will. Let the medical community treat you to their best and fullest extent. Then if it fails, and only then, should the medical providers learn from the family members that there was a living will so it is okay to pull the plug on the life support once it is clear that the care is useless and futile.

This new infatuation will living wills is going to have the unexpected result of lots of people dying when they could be saved and would want to be saved because the situation that led to death was reversible and not covered by the written text of the living will, but nobody bothered to ask. But this will be a kind of poetic justice for our mental laziness and naivete about dealing with these matters.

-Gary Amos 22 Mar 05

http://www.wnis.com/shows/GaryAmos.shtml

Since only one web source is found, here is another source: The Google.com cache:

http://64.233.161.104/search?q=cache:rvjDvS1us6oJ:www.wnis.com/shows/GaryAmos.shtml+%22The+problem+is+that+doctors+and+nurses+don%27t+read+them%22&hl=en

* Mae Magouirk’s Living Will:

“She entered the Hospice LaGrange and in a living will, Magouirk said she wanted nourishment and fluids unless she went into a coma or a persistent vegetative state.”

“This woman has a lot more years to live,” Mullinax, the woman’s nephew, said. “She recognized us and she looked at us, and said, please, please help me go home.” Asked what he thought that to mean, Mullinax said, “It sure didn’t mean home to Jesus, and it sure didn't mean starve me to death.”

(Georgia Case Mirrors Schiavo Battle Reported By: Denis O'Hayer ; Web Editor: Manav Tanneeru ; Last Modified: 4/8/2005 11:19:46 PM, http://www.11alive.com/news/news_article.aspx?storyid=61478)

The Register asks: Did all this prevent her from being quietly starved almost to death? She had a living will and was neither PVS nor terminally ill, but, instead, quiet cognizant and wanted to get out of that place and get something to eat and drink, so there should be no problem for that, right? Answer below, and it could happen to you:

After days without water, nourishment, woman at UAB
Sunday, April 10, 2005
VIVI ABRAMS
News staff writer
An 81-year-old Georgia woman who went without nourishment and water more than a week was airlifted from a LaGrange hospice to UAB Hospital Saturday to begin treatment, relatives said. http://www.al.com/news/birminghamnews/index.ssf?/base/news/1113124997294560.xml

* One more scary case:

"Richard Routh, 42, was hospitalized with head injuries after a motorcycle accident. He had learned to signal "yes" and "no," could smile and laugh at jokes, when his parents and doctors decided to have him starved. A nurse's aide says that as they stood by the bedside discussing the starvation decision, Routh shook his head "no." Though the coroner's report says he dies of head injuries, he had lost thirty pounds during the hospitalization. The autopsy showed that he had not been given painkillers to ease the pain of starvation."

(“The Euthanasia/Abortion Connection” Feminists for Life of America, 2000, By Frederica Mathews Green © 2004 Feminists for Life) http://www.feministsforlife.org/FFL_topics/euthanasia/euthabor.htm

* If you are a LAW ENFORCEMENT Officer, please note that The Register, a pro-life publication, does not support revenge against you, but you are still vulnerable to these abuses, as shown here:

“Dr. Ronald Cranford, the euthanasia advocate who hopes to help Pete Busalacci take care of Christine when she is brought to Minnesota, had a similar case in 1979. Sgt. David Mack was shot in the line of duty as a policeman, and Cranford diagnosed him as ‘definitely … in a persistent vegetative state … never [to] regain cognitive, sapient functioning … never [to] be aware of his condition.’ Twenty months after the shooting Mack woke up, and eventually regained nearly all of his mental ability. When asked by a reporter how he felt, he spelled out on his letter board, ‘Speechless!’” (Ibid.)

* Terri Schiavo’s Living Will - The Florida and U.S. Laws and Constitution regarding protection from abuse and denials of various liberties.

* Terri Schiavo’s Living Will - A previous court ruling for her to have medical malpractice award and medical care for like fifty (50) years.

* Your living will, whether the U.S. constitution, or State or Federal protections, or court cases in your favor -or even "regular" living wills, "can and WILL" be overridden by those who are tired of you ...unless you speak up.

* Studies and statistics on PVS

Additional Authorities from the Scientific Literature: 3 Studies of PVS

STUDY 1-of-3: It is not “the wishes” of patients to accept assisted suicide or euthanasia
"In no vignette--even for patients with unremitting pain--did a majority of oncologists find euthanasia or physician-assisted suicide ethically acceptable. Patients actually experiencing pain were more likely to find euthanasia or physician-assisted suicide unacceptable." (Euthanasia and physician-assisted suicide: attitudes and experiences of oncology patients, oncologists, and the public. Emanuel EJ, Fairclough DL, Daniels ER, Clarridge BR. Lancet. 1996 Jun 29;347(9018):1805-10.) (Emphasis added)

STUDY 2-of-3: Patients “wishes” not easily predicted for physician-assisted suicide
Researchers at Duke University recently surveyed hundreds of frail elderly patients receiving outpatient treatment and their families. The elderly patients themselves strongly opposed physician-assisted suicide: only 34% favored legalization, with support even lower among female and black patients. But 56% of their younger relatives favored it, and they were usually wrong in predicting the elderly patients' views. [Dr. Harold Koenig et al., "Attitudes of Elderly Patients and their Families Toward Physician-Assisted Suicide," 156 Archives of Internal Medicine 2240 (Oct. 28, 1996).] (Emphasis added)

STUDY 3-of-3: “PVS” is misdiagnosed in almost half of all cases
Catholic World News — News Brief — 07/18/2000
Study Says Some Comatose Patients May Be Aware
LONDON (CWNews.com) - A new study carried out in London showed that many comatose patients diagnosed as being in a persistent vegetative state (PVS) may actually be aware of their surroundings and able to communicate.

The Daily Mail newspaper reported on Tuesday on a study carried out by the Royal Hospital of Neurodisability on 40 presumed PVS patients that 17 [roughly 42.5%] of them were misdiagnosed. Two-thirds of the misdiagnosed patients were thought to be in a PVS because their eyes failed to follow movement, when they were actually blind. All of them had limited movement and thus had difficulty communicating.

Dr. Keith Andrews, director of medical and research services at the hospital, warned that PVS patients "may spend a lifetime trapped in a damaged body, with poor quality of life." Lorraine Lane, one such patient, was thought to be in a PVS and her husband was applying to the courts for an order to end her life until she squeezed his hand to prove some degree of awareness.

* You next, big Dog? Just lose you voice - go ahead - just do it!

*PRACTICAL POINT - it could happen to you.* What if YOU are in a hospital, and possibly able to eat and drink, even if it's only applesauce or milkshakes and Jell-O, would YOU like to be deprived of a chance to drink some cool, sweet grape juice, apple juice, water, etc.? (That is, when a person's going to die anyhow, what's to lose by trying to east and drink?)

Remember that many of Terri’s caregivers have said that Terri was able to eat things like Jell-O, milkshakes, and ice chips. In case you’ve forgotten, here’s that “PVS” person:

http://gordonwatts.com/ConversationWithTerri.wmv mirror at:
http://hometown.aol.com/GordonWWatts/myhomepage/ConversationWithTerri.wmv

Doesn’t look to “PVS,” does she? (If YOU have a speech impediment or partial paralysis, and you’re around a bad-attitude nurse, when you’re really hungry -and your mouth is watering for thirst…)

* Patients of “Dr. Death,” Dr. Jack Kevorkian, who though are willing, and it is "their wishes" to be killed, are protected by law.

* Friends of the rock band, “Hell on Earth,” are not unlike Dr. Kevorkian’s patients. Do you remember this Clearwater, Florida band? They attempted a staged suicide, and it was that fellow's "wishes," but even *then* this act was stopped. (How much more for Terri Schiavo or others whose wishes are not known?)

* We are prohibited from starving dogs and cats, which cannot always feed themselves but must be fed by humans. Would we let them starve to death? Would it even be legal? Moral? Practical? Possible?

* There are plenty of physically handicapped and mentally retarded people who, like Terri Schiavo, cannot feed themselves. Would we let them starve to death? Would it even be legal? Moral? Practical? Possible?

* We all have many elderly family and friends, like Pope John Paul II, above. Would we let them starve to death? Would it even be legal? Moral? Practical? Possible?

* Don't lose your voice or have partial paralysis in your next hospital stay, Bub; you could be next.

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