LETTER
Whose Death Is It, Anyway
Charles R. Routh, MD
1 April 1997 | Volume 126 Issue 7 | Page 586
TO THE EDITOR:
I enjoyed the essay by Hansot [1] and the related article by Gilligan and Raffin [2]. However, I believe it is misleading to imply that had the patient, family, and physician known that the patient had a living will, this nightmare would have been avoided.
Most living wills go into effect only if the patient has a "terminal illness." Therein lies the rub. What is a terminal illness? What about an 87-year-old man who is slightly hypokalemic and fibrillates within hours of his first inferior myocardial infarction? Is this a terminal illness for which we invoke the living will and do not defibrillate? The point is, either I'm a bad doctor or many of us simply can't tell when a given illness or situation should be considered "terminal" and thus necessitate invocation of the living will.
Living wills are hardly worth the paper they are printed on. Letting family members know as clearly as possible the circumstances under which you would want certain interventions may be the better path to take.
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Author and Article Information
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Muncie Internal Medicine, Muncie, IN 47303-4774
1. Hansot E. A letter from a patient's daughter. Ann Intern Med. 1996; 125:149-51.
2. Gilligan T, Raffin TA. Whose death is it, anyway? Ann Intern Med. 1966; 125:137-41.
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