Dying With Dignity or Avoiding The High Cost of Dying
Since the Karen Ann Quinlan case, national attention has been focused on such issues as “quality of life” and the “right to die,” and the ethical questions of prolonging life in hopelessly ill people. Stories abound of people in comas with incurable diseases who are being kept alive “thanks” to the so-called marvels of modern technology. As Thomas and Colin Scully say in their book Playing God: The New World of Medical Choices (New York: Simon & Schuster, 1988), “For the first time in history, physicians have the ability, know-how, and sophisticated technology to sustain the physical life of patients beyond any reasonable quality of life they may want to endure.”
Traditionally, the physician has been solely responsible for deciding when life is to be allowed to end and when further effort is to be expended to keep the person alive—an awesome power that too often has resulted in the overtreatment of the dying. But in recent years such medical practices have flown in the face of the burgeoning consumer movement and its attendant emphasis on patients’ rights and patient autonomy. The consequence? Change is in the wind and, in many cases, states’ laws.
The right-to-die movement, a movement away from impersonal technology to personal choices, is underway. If it is important to you to die with dignity, and to maintain autonomy over future legal and medical decisions made on your behalf, then you need to do some advance planning now. And that’s what this section is all about. We will attempt to help you with this planning by explaining how you can use living wills and durable powers of attorney for health care to maintain your autonomy—and to ensure that the money you or your family spends on medical care is allocated according to your wishes. Not that these life-and-death decisions are made on the basis of economic considerations, but if spending lavish sums of money on life-sustaining technology is the last thing you want to do, then plan you must. Because without planning this just may end up being the last thing you ever do. But first you need to know the terms, starting with the most basic—and most complex.