We have 'Baby Does' now. It won't be long before we have 'Granny
Former Surgeon General C. Everett Koop.
It is every person's right to control his or her own body. A natural
and logical extension of this "right to choose" is the right
to determine how one will be treated if one is incapable of voicing an
opinion regarding one's own medical care.
Most people do not want to go on living as hopeless vegetables after
they lose the capacity to make decisions. This prospect fills us with
dread and is an unconscionable invasion of privacy. The "Living
Will" fills the vital need of allowing individuals to specify what
medical care is and is not desired after he or she is rendered
What is a "Living Will?"
"Living Will" legislation goes by many names. It may be
called "Death With Dignity," "Rights of the Terminally
Ill," or "Patient's Rights" legislation. All of these
names emphasize understanding and compassion.
The "Living Will" is defined by pro-euthanasia groups as a
document by which a person can assert, in writing, a desire not to be
kept alive by life-sustaining medical equipment and procedures when his
or her condition has been diagnosed as terminal, or under certain other
Most "Living Wills" signed in this country today are
form-type wills, but, as with any legal document, they can be
custom-tailored to meet any actual or perceived need or wish, including;
• requesting or refusing artificial feeding tubes, antibiotics,
respirators, cardiopulmonary resuscitation, and other
• requesting pain medication;
• stating the desired place of death, including at home;
• designating a proxy to make health care decisions when the
incapable of doing so; and
• requesting designation as an organ donor.
Is A "Living Will" Necessary?
Some persons believe that the "Living Will" is necessary in
order to clarify a patient's legitimate right to refuse extraordinary
medical treatment. However, this is a right that all patients already
possess. Public support for such pro-"Living Will" legislation
is primarily due to the fact that a very small minority of doctors
resist even morally appropriate requests for the withdrawal of
"Living Wills" are generally unnecessary under present law,
because there is nothing to prevent doctors from withholding or
withdrawing life-sustaining medical treatment when all reasonable hope
for recovery is gone. Patients already have the right to give their
doctors and family instructions on how they want to be treated in the
event of a terminal illness or grave injury, particularly when they are
in no condition to decide for themselves.
Who Backs the "Living Wills?"
Most "Living Will" proposals have been written and promoted
by the following organizations. The membership of this list alone should
sound alarm bells for those dedicated to protecting human life;
• The Society for the Right to Die, which shed its
"Euthanasia Society of America" in 1975;
• Americans Against Human Suffering (AAHS);
• Concern for Dying (formerly the Euthanasia Educational Council),
split from the Society for the Right to Die in 1979;
• the National Hemlock Society, which lobbies for direct euthanasia,
which publishes a "cookbook," or
"how-to" manual on suicide; and, not
• the American Civil Liberties Union (ACLU).
In fact, the original concept of the "Living Will"
originated with these pro-euthanasia groups. The "Living Will"
is seen as a publicly-acceptable way to introduce the agenda of
legalized active euthanasia, suicide, and assisted suicide.
Notice that none of these organizations uses the term
"euthanasia" in their titles (they prefer the euphemisms
"right to die," "death with dignity," and
"mercy killing"). Note also that all of these groups operate
primarily in California, Arizona, and Florida, all states with large
elderly and retired populations.
Just the First Step ...
The Three-Step Strategy.
Pro-euthanasia activists consider the "Living Will" just
the first step on the road to active, involuntary euthanasia of
those considered to be useless to society. They know full well that if
they can get society to make this first critical step, all of the other
steps no matter how many there are will be much easier.
Subsequent steps are always easier. The first step down the slippery
slope is the hardest, but, once a society's downward plunge gathers
momentum, it will find itself moving so quickly that it is difficult to
stop or turn back.
As Derek Humphry, the Director of the Hemlock Society, said in a
December 18, 1986 interview; "We have to go stage by stage, with
the living will, with the power of attorney, with the withdrawal of
this; we have to go stage by stage. Your side would call that the
'slippery slope'... We would say, proceed with caution; learning as we
go along how to handle this very sensitive situation." The
headline of an August 16, 1985 USA Today article which was a
compendium of interviews with pro-euthanasiasts said it all:
"Living Wills 1st Step, Euthanasia Group Says."
The "Living Will" is only the first of three major steps in
the pro-euthanasia strategy. The second is passive euthanasia (assisted
suicide). In such an action, the doctor prescribes a lethal dose of
medication at the request of the patient, or he discusses how a
hypothetical patient, using hypothetical means (of course) can kill
Dr. Jack ("The Dripper") Kevorkian is now making this
second step a reality. As of March 1993, the retired Michigan
pathologist had assisted in the suicides of fifteen people, and had made
it perfectly clear that he wanted to set up a chain of euthanasia
clinics across the country, as described in Chapter 109, "History
The third and final step in the strategy is direct euthanasia, where
the patient or his "attorney-in-fact" requests that the
patient be injected with a combination of barbiturates and paralyzing
drugs. This type of direct killing was proposed in the "Oregon
Death With Dignity Act" and Washington State's Initiative 119,
which failed by popular vote in November of 1990.
This three-step strategy for direct euthanasia was demonstrated
vividly after California passed its "Natural Death Act" in
1983. Within just the first year after its passage, seven
amendments were made to this Act, each of which substantially expanded
its original intent. The Hemlock Society supported a proposed bill that
would have allowed doctors to give their patients lethal injections in
other words, direct euthanasia.
The Future of the "Living Will."
As with the other aspects of euthanasia, we need only to look to
Holland for a vivid picture of the future of the "Living Will"
and its natural successors.
Dutch cardiologist Dr. Richard Fenigsen recently described the
ultimate evolution of the "Living Will" in Holland.
More than 40 percent of all Dutch physicians have admitted to killing
one or more of their patients against their wills. In light of
this fact, most Dutch, especially the elderly, are extremely afraid of
doctors and, even more so, of hospitals.
The number of nursing homes in Holland has decreased by more than 80
percent in the last 20 years, and the life expectancy of the few elderly
who remain in such homes is becoming shorter all the time. In some
cases, the life span of healthy elderly who enter Dutch nursing homes
can be measures in hours.
Many Dutch citizens, therefore, are now carrying a defensive document
entitled the "Declaration of a Will To Live," which states
that they do not want to be euthanized without their knowledge.
This document was originated by the appropriately-named Sanctuary
Predictably, these Declarations carry very little weight with the
same doctors who introduced the equivalent of the so-called "Living
Wills" in Holland. As always, what matters is not what the patient
desires, but what the physicians see as beneficial to the medical
profession and to society at large.
As Dr. Fenigsen noted, "The burden of justifying his existence
is now placed upon the patient."
What Are the Dangers of
the "Living Will?"
No Reliable Oracles.
The primary danger of the "Living Will" lies in the fact
that it is usually signed long before the person knows when he or she
will be incapacitated or what the circumstances of that incapacitation
will be. This means that the specific treatment (or lack thereof) for
the future condition cannot be specified.
Presumably, one can revoke a "Living Will" at any time by
making a verbal or written statement to a physician, nurse, or other
health care worker. This, of course, is contingent upon the individual's
condition at the time he wishes to change his mind. If he should
experience a change of heart after he is incapable of communicating, he
is out of luck. Also, if the presiding health care professional feels
that the patient's wishes are the result of trauma or some other cause,
they can be totally disregarded.
If a "Living Will" has been signed, it is probably legally
binding under the current conditions in the American judicial system. It
would therefore be difficult or impossible for a family doctor to make
the decisions which could be in the patient's best interests.
This set of conditions makes it virtually impossible for the signer
of a "Living Will" to define precisely that treatment that he
wants or does not want.
An example "Living Will" is shown below in bold type. The [bracketed
and italicized sections] highly the extreme vagueness of the
so-called "Model Living Will" that is being proposed for
general usage in every state by pro-euthanasia groups.
INTRODUCTORY TEXT OF A TYPICAL 'LIVING WILL'
If I should have an incurable or irreversible condition [does
this include asthma, diabetes, cerebral palsy, heart conditions, AIDS?]
that will cause my death within a relatively short time, [this
could be hours or weeks or even months] and if I am no longer able
to make decisions [what if the person is affected by medication or
allergies? What if he is temporarily disoriented or depressed? Or
senile?] regarding any medical treatment, I direct my attending
physician [family doctor? Friend? Attorney-in-fact? What about a
doctor in a strange city who knows nothing about you?] to withhold
or withdraw treatment [what about respirators or chemotherapy? How
about insulin, nitroglycerin, blood pressure medicine, oxygen,
antibiotics, even food and water?] that only prolongs the dying
process and is not necessary to my comfort or to alleviate pain [if
you are transitorily comatose or drugged, what degree of pain is being
Reference. "Living Wills."
Pamphlet by Mary C. Senander, Human Life Alliance of Minnesota, Inc.,
Post Office Box 293, Minneapolis, Minnesota 55440. 1986.
A person may feel justified and secure in signing a "Living
Will," but, even if the document were medically and legally secure
in every way at the time of its signing, there is no way of
knowing how the definitions and rules will change as the pro-euthanasia
groups lobby and push for more favorable (for them) conditions.
Take as an example the most common "form" "Living
Will," which has been signed by millions; "If I am permanently
unconscious or there is no reasonable expectation of my recovery from a
seriously incapacitating or lethal illness or condition, I do not wish
to be kept alive by artificial means."
Ten years ago, "artificial means" would have meant truly
extraordinary or "heroic" medical or surgical procedures. Now,
in some states, respirators, codes, kidney dialysis, and even food
and water are defined as "artificial!" In other words, a
person might sign a 'Living Will' in a state where food and water are
standard treatment, and then travel to a state where they are defined as
"extraordinary treatment," and become incapacitated. Or else,
the courts or legislator in his home state may quietly define food and
water as "extraordinary treatment," and he will not be aware
of the fact.
What happens then?
Terms whose definitions are constantly shifting or are difficult to
define are the heart of the "Living Will's" problems. Figure
111-1 lists the ten primary objections to current "Living
THE TEN BASIC LOGICAL OBJECTIONS TO THE "LIVING WILL"
(1) The "Living Will" is unnecessary because everyone already
has the right to make informed consent decisions about their own
(2) The "Living Will" is unnecessary because doctors are already
free to withhold or withdraw useless procedures that provide no
comfort or profit to terminal patients.
(3) The "Living Will" is unworkable because it is theoretically
impossible to make well-informed and logical decisions regarding
health care before illness or accidents happen. Nobody even knows how
they will react if they are incapacitated.
(4) "Living Will" language appears to be precise, but in
reality it is extremely vague, and can be interpreted in an almost
unlimited number of ways, many contrary to the actual intent of the
(5) The "Living Will" is counterproductive because
doctors are currently protected from malpractice suits to a certain
degree when dealing with terminal cases. However, the addition of a
relatively random legal element such as the "Living Will"
greatly increases the possibility of malpractice claims by surviving
relatives due to the extremely vague language of the "Living
Will." Physicians are in the midst of an acute malpractice
crisis. A doctor may take the safest course of action for himself and
withhold treatment that would preserve the life of the patient in
cases where there is some question brought on by the vagueness of the
"Living Will" language. In other words dead patients don't
(6) The "Living Will" is counterproductive because it may
restrict physicians and relatives from making health care decisions
that are truly in the best interests of the incapacitated signer.
(7) The definitions contained in a "Living Will" are
constantly changing. For example, the term "heroic
treatment" may soon evolve to include food and water. Therefore,
a person signing a "Living Will" now may have
unintentionally signed his own death warrant by starvation and thirst
if he does not carefully keep up with legislation in the area of
health care decisions. And it is a safe bet to say that 99 percent of
"Living Will" signers do not do this.
(8) Legally binding fill-in-the-blank "Living Wills" do
not make age distinctions. A person who might refuse a certain
life-sustaining measure if he were dying of brain cancer at age 85 may
not refuse the same treatment if he were the victim of a car accident
at age 25. The "Living Will" makes no distinctions in this
(9) The "Living Will" is dangerous because it does not
completely define the complex term "competency." Therefore,
a person who decides to contradict one or more of the specifications
in his own "Living Will" might be refused because he is
ruled technically "incompetent."
(10) The "Living Will" is dangerous because there is a
heavy push on for cost containment and socialized or nationalized
health care. The widespread use of "Living Wills" will
insure that the balance tips towards undertreating patients,
which has killed a thousand times as many people as overtreating
Emergency Room Intruder.
If "Living Wills" become popular, their existence will
vastly complicate hospital decisionmaking. How would a doctor treat a
patient who has not signed a "Living Will?" Would he
expend every effort possible to save the patient? Or no effort at all,
in the belief that the person wanted no treatment whatever? If a
significant percentage of the population had signed "Living
Wills," would it be assumed that every possible effort should be
expended to save all emergency room patients? How can the physician be
certain that a person has or has not signed a "Living Will?"
Perhaps uppermost in the physician's mind is the fact that failure to
comply with a legally binding "Living Will" would make him
liable for damages. What would he do if confronted with an emergency
situation where the status of the patient's "Living Will" were
unknown? Would he proceed with treatment that might be against the
patient's wishes? What would he do if the "Living Will"
specified some action or lack of action that conflicted with his
religious beliefs, or with hospital regulations? What if a
custom-written "Living Will" featured particularly bizarre or
dangerous specifications based on personal beliefs?
The personal beliefs of doctors, of course, carry little weight in
the legal system. This will inevitably lead to physicians being forced
to choose between their consciences and their jobs and security. Doctors
will be forced to choose death over life.
In fact, some states now require that a doctor not only try, but
actually find another physician willing to kill the patient,
under pain of severe penalties in some cases, even jail terms.
The Current Status of "Living Will" Legislation.
As of the end of 1990, 38 states and the District of Columbia have
"Living Will" statutes. The status of this legislation, and
the protections offered or withheld, is summarized in Figure 111-2.
STATUS OF THE 'LIVING WILL' AS OF DECEMBER 1990
Mississippi (1984) 
Missouri (1985) 
Montana (1985) 
Nevada (1977) 
New Hampshire (1985) 
New Mexico (1977) [2,5]
North Carolina (1983) [3,5]
Oklahoma (1985) 
District of Columbia (1982) [2,5] Oregon (1977) [1,5]
South Carolina (1987) 
Tennessee (1985) [1,5]
Texas (1977) 
Utah (1985) 
Vermont (1982) [2,5]
Virginia (1983) [2,5]
Washington (1979) 
West Virginia (1984) [2,5]
Wisconsin (1984) 
Wyoming (1984) 
Maryland (1985) 
 These states exclude nutrition and hydration from the
definition of "life-sustaining procedures" that may be
included or excluded by the patient's "Living Will."
 These states do not specifically mention the status of
nutrition and hydration in their "Living Wills," because
most of their laws were enacted before 1984, when nutrition and
hydration were considered separate from medical treatment. Eleven of
these states and the District of Columbia, although silent on the
matter of nutrition and hydration, offer some protection due to rigid
definitions of the terms "imminent death," "terminal
condition," and "life-sustaining procedures."
 States that have passed "Living Will" legislation
that is silent on the status of nutrition and hydration and offer no
real protection due to their loose definitions of "imminent
death," "terminal condition," and "life-sustaining
 In 1986, Alaska passed legislation which includes nutrition and
hydration in its definition of life-sustaining treatment that may be
withdrawn. This is the most liberal and frightening "Living
Will" statute on the books. Significantly, it is considered the
most ideal existing "Living Will" by "Right to
 In accordance with the Supreme Court abortion decision Roe
v. Wade, these states allow "Living Wills" for pregnant
women. This means that a woman may be euthanized even if her baby is
full-term. Even those states that do not allow the killing of a
pregnant woman have endured strong challenges from those who believe
that she should be allowed to not only commit suicide, but
References. "Living Wills." Human
Life News (publication of the Washington State National Right to
Life affiliate), November/December 1988, page 2. Also see "Guide to
the Living Will." Hippocrates Magazine, May/June 1988, page
60. Also see Society for the Right to Die. Handbook of Living Will
Laws, 1981-1984, Handbook of 1985 Living Will Laws, and
References: The "Living Will."
 Derek Humphry, quoted in Leslie Bond. "Hemlock Society Forms
New Organization to Push Assisted Suicide Initiative." National
Right to Life News, December 18, 1986, pages 1 and 10.
 Presentation by Dutch cardiologist Richard Fenigsen, M.D., Ph.D.,
at Seattle University on November 2, 1990. Described in "Holland
Euthanasia Experience Described." Human Life News
(Washington State). November/December 1990, page 6.
Further Reading: The "Living Will."
Paul A. Bryne, M.D. Understanding Brain Death.
Order from American Life League, Post Office Box 2250, Stafford,
Virginia 22554. Is "brain death" really the death of the
person? This booklet examines this critical question.
Father Robert Barry, O.P. Protecting the Medically Dependent:
Social Challenge and Ethical Imperative.
Order from American Life League, Post Office Box 2250, Stafford,
Virginia 22554. How to construct, ethically and legislatively, a proper
plan of protection for the seriously ill.
A.R. Saqueton, M.D. In Defense of Life.
ARS Publishing Company, Post Office Box 6444, Stockton, California
95206. 232 pages, 1981. Reviewed by Felicia Goeken on page 9 of the May
10, 1982 issue of National Right to Life News and page 11 of the
July 8, 1982 issue of the same publication. Also reviewed by Robert L.
Sassone on page 20 of the May 1982 issue of ALL About Issues. One
of the most valuable references available on "right to die"
legislation. The 'Right to Die,' Living Wills, terminal conditions, and
many other aspects of euthanasia are covered in this primer-type work.
Society for the Right to Die. Refusal of Treatment Legislation:
A State By State Compilation of Enacted and Model Statutes.
Society for the Right to Die, 250 West 57th Street, New York, New
York 10107, telephone: (212) 246-6973. This ring binder includes the
full text of every living will and durable power of attorney statute in
the United States, the model statute entitled the Uniform Rights of the
Terminally Ill Act, and summaries and highlights of the significant
features of all of these documents.
© American Life League BBS — 1-703-659-7111
This is a chapter of the Pro-Life Activist’s Encyclopedia published
by American Life League.