Question

A 60-year-old man suffering from high blood pressure has been seeing a doctor for 2 years. One night he collapsed while taking a bath at home and then was taken to ER, diagnosed subarachnoid hemorrhage. Eventually, he became to be in a brain death condition. He has executed a living will which mentions that he does not wish any treatment for life extension when there is no possibility of recovering from coma condition. Which means, according to his living will, his doctor needs to take a ventilator away from him soon. His wife, however, is not prepared for that moment and asked the doctor to wait for a little more time although she has known about her husband’s living will very well. She seems to be stable when she is staying by his bed, but when the doctor talks to her about taking a ventilator from him, she becomes emotional so that the doctor cannot go on to the next step. The doctor is afraid of that she will be suffered from mental illness if the ventilator was taken away from her husband while the doctor concerns the patient’s living will. The couple has two daughters and a son who are both in their 30s and 20s, and 3 grandchildren. They are all living around the town and come to a hospital few times a week. The family relationship is very well.

Questions

1. How should the balance between a living will and family’s wish be taken in this case?
2. What would you do if you were his doctor? How about if you were one of the children of the couple?

3. Is a living will always prior to other’s request? What are the legal perspectives on a living will in your country?

4. Is the patient’s right violated because his living will have been ignored?

5. If a ventilator is taken away from the patient against his wife’s request, is it possible to say that the wife’s right or dignity was ignored by a sole interest of society which here is a system of “living will”?

Answer 1

A living will is a document that contains one's wishes regarding medical procedures to be carried out when a person is nearing death. Advanced medical directive is made as a variation to living will wherein the patient's caregivers or closed ones are likely to make the choices regarding the medical procedures of removing the life sustaining process or continuing them. However, this too is mostly wit the consent of the patient himself. In this case a supportive team work is required in order to help the women cope with the situation and explain why this is important from a legal standpoint. The situation needs to be brought under control and then the required measures must be taken by the medical team.

As the team, we would require a mental health team as well to provide supportive work for dealing with the complex situation. As the children, the priority would be to help the mother cope with the situation. This can be done by creating a safe net for wherein she can express her emotions and thereby deal with them at her own pace. Loss is something that leads to a grief cycle and most people have a different pace of going through that cycle.

The above two types of variations are available as living will variation and need to be followed as a protocol from a legal perspective in the nation.

Indeed if without the patient's consent is not catered to, the right of his choice in this regard is violated.

If the wife's request is ignored, it is possible to say that the wife’s right or dignity was ignored by a sole interest of society which here is a system of “living will”. But it is a step which is ideally to be taken in such cases, especially where the living will is provided by the patient himself.