They can open the door to a positive, caring approach to death

Papers p 1640

Many people are unaware of living wills but are highly interested once they hear about them. In this week's BMJ Schiff et al (p 1640) find that elderly inpatients are confused by the term living will, but most would welcome the chance to discuss issues about facing the end of life, and many would want to limit their health care if they were terminally ill.1 An assessment of the understanding of living wills in the United States some time ago found a similar state of affairs.2 This juxtaposition of ignorance and interest raises an important question: what is this apparent appetite to discuss and prepare for dying?

When lawyer Louis Kutner proposed the notion of a living will in 1969, he was responding to the fear that technology was driving doctors to impose life sustaining treatment on patients who might not want it. The living will was seen as a simple device to allow patients to say no, even if they were too ill to …