Living Wills Do Not Work

The Hastings Center Report article on living wills' failure has drawn notice pretty much everywhere in the major media. Many others have made similar claims (e.g., here), but this piece is quite good and apparently timely as well.

Living wills have become one of bioethics' most embarrassing failures - an imaginative idea that has the support of the majority of bioethicists despite a total lack of support for their efficacy. From the start it has been clear to at least some of us that these documents just make things more confusing and litigious. An incredibly imaginative experiment, it is time to call living wills just that - an experiment, based on little data and thrust out into the medical community at large on the strength of a few prominent persistent vegetative state cases. Given the coverage of this most recent missive in the debate about how to handle patient wishes at the end of life, it will be interesting to see if hospital ethics committees continue to assert that living wills are a smart thing for patients to have.

It is high time for some legislative retooling of the Patient Self-Determination Act and supporting state legislation. The experiment has failed. Time to pull the plug.

Living Wills Have "Failed"

Here in the Miami Herarld is an account of a recent paper in the Hastings Center Report, which describes the failure of living wills- paper documents that list medical choices if you become terminal and incapacitated. A more helpful thing to do- although by far not foolproof- is designate a trusted surrogate to make your end-of-life choices. "Another choice that holds less legal weight but perhaps more influence: thoughtful conversations in advance with your regular doctors." -Dominic Sisti

Face Transplantation

The New York Times has devoted an essay in its health section today to The American Journal of Bioethics Target Article on Face Transplantation. The story has, Taylor & Francis tells us, been front page news in - get this - more than 800 newspapers worldwide. The Times piece, though, is the first significant mass media editorial on face transplantation and it puts a bioethics journal squarely into the mix. We're pretty happy about that. It is all the more rewarding that the exchange comes from our friends at Hastings Center!