living willMost people are frightened not so much by the fact of death as by the process of dying. A natural, peaceful death is much to be preferred over a meaningless and prolonged artificial existence. A life prolonged as a result of increasingly sophisticated technology can drain your family emotionally - they are compelled to endure your condition. In addition it may drain your own financial assets and those of your immediate family.
In a Living Will you can express your rational choice of when to discontinue life support and when to withhold treatment of a fatal illness if you are already suffering from a life-threatening condition. Doctors may be reluctant to accept the decisions of a seriously ill patient because of uncertainty about his/her rational state of mind. As a result, your health care providers have some legal protection, which may lessen the chances of a lawsuit against them.
Your ability to pre-determine the precise circumstances in which further treatment should be withheld is very important, as well as stating which members of your family should have the power to decide at what point to withdraw life support.
A Living Will does not carry the same legal status as that given to a Last Will and Testament in England or Hong Kong, although it is legally accepted in the USA and Australia. Living Wills must be made at a time when the Testator is in full possession of his or her mental faculties and may be revoked or altered at any time prior to mental incapacity. It is advisable to review (and revise if necessary) a Living Will every two years so that it reflects an up-to-date statement of your wishes. SAR International will ensure that you are reminded regularly to review the document.
The British Medical Association strongly supports the principle of Living Wills, and recognises the appointment of health care proxies (a proxy is a person appointed by you to act on your behalf and in accordance with your instructions.) It is helpful in communicating your views if you are no longer capable of expressing them. It should however, be noted, that no person has a legal right to accept or decline treatment on behalf of another adult.
Therefore, doctors are not obliged by their professional ethics to comply with a Living Will, but must be prepared to allow other doctors to take over the treatment of a patient who has expressed a wish, in writing, about his or her treatment. It is strongly recommended that a Living Will should be drawn up with the knowledge and co-operation of your General Practitioner and any other doctors who are concerned with your treatment. Once signed, a copy of the Living Will must be lodged with your GP. Doctors who have conscientious objections to the principle of a Living Will should advise their patients of their views at the outset. Living Wills cannot be used to insist upon specific treatments (for example, euthanasia).
At time of writing, the Hong Kong Government has issued a consultative document on Living Wills, but no formal policy has yet been agreed. More information on this topic can be found at www.hkreform.gov.hk/reports/index.htm.
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