PA law clarifies end of life issues
A new Pennsylvania state law that takes effect Jan. 29 is expected to protect patients and health care providers from problems related to living wills. Living wills, which are called “advance directives” under the law, have caused many problems in Pennsylvania. For example, the terminally ill resident of a nursing home might have a living will that specifies he doesn’t want last-ditch life-saving measures if there is no chance of recovery. But a medical emergency might send him to the hospital. The hospital might disregard the living will, perhaps believing that it didn’t apply outside the nursing home, or fearing that it could be sued for denying treatment.
The patient might end up on life-support equipment against his and his family’s wishes, wracking up large medical bills for pointless treatment. At the other extreme, someone with a good chance of recovery might be denied life-saving measures because caregivers knew he had a living will and assumed it included “do-not-resuscitate” instructions. Advance directives are commonly used to inform health care providers that someone doesn’t want treatment such as breathing help with a ventilator or a feeding tube if they have no chance of getting well. Health care providers commonly turn to such directives with terminally ill patients who are unconscious or mentally incompetent. These directives also can be used to inform medical professionals that a person wants any treatments that might prolong life. The issue received national attention when courts and Congress became involved in the decision on whether Terri Schiavo, a brain-dead Florida woman, should have her feeding tube removed.