Doctors and other medical professionals often take it upon themselves to assess a patient's quality of lifeDoctors frequently make medical decisions about the quality of life a patient has, based on their own opinion and often without asking the patient how he or she regards the quality of their own life. This is highlighted in the following report.
- When doctors try to persuade patients to sign a Living Will, they often play on people's negative assumptions about impairment.
- Doctors frequently fail to mention what support can be obtained from agencies and organisations.
- A Living Will can put your life in the hands of someone who may interpret the words in a way you may not expect.
- After the shock has worn off following a negative diagnosis, and the usual depression is treated, people facing a future with an incurable disease can be surprised how much they ejoy life.
Older Patients Choose Quantity Over Quality of Life
The Lancet (7 Feb. 98) reported: "Given the choice, would frail and elderly people prefer to live as long as possible, or would they choose a shorter but healthier life? A new study suggests the former." 69% of the 414 patients aged 80-98 investigated at the University of Cincinnati Medical Center, USA "were unwilling to trade more than one month of life in 12 in exchange for excellent health" (JAMA 1998; 279: 37175). But surrogate decision makers were not always aware of their charges' preferences.
People will be asked to imagine their life if they had cancer, advanced dementia, were doubly incontinent or 'confined' to a wheelchair.Disability Tribune Article
"The Hammersmith Hospital Trust is planning to ask older people to write a Living Will which would inform doctors when to stop medical treatment should their health deteriorate", reported Disability Tribune, the magazine of Disability Awareness in Action, the international disability and human rights information network, in March 2003."
However doctors intend persuading people to sign such a document by playing on people's negative assumptions about impairment. People will be asked to imagine their life if they had cancer, advanced dementia, were doubly incontinent or 'confined' to a wheelchair.
"What is alarming is that yet again the medical profession have deemed themselves 'the experts' in deciding what is an acceptable or unacceptable quality of life. Indeed the doctors will almost certainly fail to mention what support statutory agencies can make available should the individual decide to ignore the 'living will' option.
"...the reality of ceasing medical treatment, which since a recent court decision includes food and water, can mean a slow and painful death.""The decision to introduce this policy was taken after a survey, funded by the hospital trust, showed that older people would rather not have their lives prolonged by medical treatment if they were terminally ill. Instead they would rather be 'kept warm, comfortable and free from pain.' However, the reality of ceasing medical treatment, which since a recent court decision includes food and water, can mean a slow and painful death."
The Medical Ethics Alliance commented on this leading hospital's pilot scheme:
"Patients should beware of the implications of what they sign up to, as one effect of signing, as the [Sunday Telegraph] article correctly explains, is to put yourself into the hands of those who may interpret the piece of paper in a way you had not expected. What is more, your relatives may not be able to help you."
"The realisation that I had an incurable disease, that was likely to kill me in a few years, was a bit of a shock."
Stephen Hawking and Motor Neurone Disease
On his website, British physicist Stephen Hawking says: "The realisation that I had an incurable disease, that was likely to kill me in a few years, was a bit of a shock. How could something like that happen to me? I felt somewhat of a tragic character.
"I suddenly realised that there were a lot of worthwhile things I could do if I were reprieved. Another dream, that I had several times, was that I would sacrifice my life to save others. After all, if I were going to die anyway, it might as well do some good.
"But I didn't die. In fact, although there was a cloud hanging over my future, I found, to my surprise, that I was enjoying life in the present more than before." Read more about Stephen Hawking here.
According to disability rights action groups, "Better Dead than Disabled!" was the message being heard in Hollywood at the 2005 Oscars in movies like Clint Eastwoodâ€™s Million Dollar Baby, and The Sea Inside. Meanwhile, they say, back in the real America, millions of people with disabilities and those who are aging, are fighting to stay alive and in their homes and communities in the face of unprecedented cuts in the nationâ€™s, institutionally biased, Medicaid program.
A press release from the organisation, Not Dead Yet stated:
"Clint Eastwood's Million Dollar Baby swept the awards, winning for Best Actress, Best Supporting Actor, Best Director and, finally, Best Picture. Alejandro Amenabar's The Sea Inside was voted Best Foreign Film. The message from the Motion Picture Academy voters? The best "cripple" is a dead "cripple." Both films centered on sympathetic portrayals of the killing of quadriplegics."
"This is a clear statement on the Hollywood industry's opinion of people with disabilities," says Diane Coleman, president of Not Dead Yet, a national disability rights group opposed to legalization of assisted suicide and euthanasia. "They grudgingly made accessibility changes when Chris Reeve complained about accessibility at the Kodak Theater, where the Oscar event is held. They love us if we're begging for a cure or begging to die. Once we start talking about our rights, we see their interest and sympathy disappear."