Today, medical equipment and technology allow physicians to sustain a person in a vegetative state for many years without any hope of recovery. Individuals who do not wish to be kept alive by such sophisticated life-sustaining techniques must put their desires in writing.
In the now famous case of Cruzan v. Dir. Mo. Dept. of
Health, 110 S. Ct. 2841 1990, the U.S. Supreme Court held that a state may
demand clear and convincing proof of a person’s wish to exercise his or her right
to die. Ms. Cruzan was an accident
victim who had not made clear her intent to have medical support
withdrawn. Because of this failure, she
could have been kept “alive,” in a vegetative state, for many years, at an
estimated cost of $200,000 per year.
The emotional toll on her family was incalculable.
Most states, including Maryland, recognizes some form of the
living will, sometimes called a right to die or directive to physicians;
however, such documents may not give the required “ clear and convincing”
proof.
Many states, including Maryland, have provided for durable
powers of attorney for health care or other formal health care proxies. These documents allow a person to appoint
another person to make health care decisions for them if they became unable to
do so.
The American Medical Association sets forth four medical
situations in which a person may find himself.
As these are read, one might ask,” Would I want medical support
withdrawn in this situation?”
·
In a coma with no hope of recovery;
·
In a coma with a small likelihood of recovery with permanent
brain damage;
·
Afflicted with brain damage or disease, severe in nature,
and a terminal illness, such as cancer;
·
Afflicted with brain damage or disease, severe in nature,
but without terminal illness.
In these situations, and others, decisions must be made
concerning the treatment which should be withheld ( for example, artificial
respiration, medicine, food, water, etc.).
Durable powers of attorney generally empower the appointed
agent to make decisions such as admission to a nursing home, consent for
surgical operations, and care in the event of senility or other disability.
In view of the Cruzan case, it seems advisable to be very
specific as to then life support equipment should not be used or when it should
be withdrawn. There are no guarantees
under the current state of the law, but clearly setting forth one’s desires in
written form should give some peace of mind.