A Statement in Opposition to "Living Wills" and "Advance Medical Directives"
That a competent conscious adult has the right to refuse medical treatment is well-established, even when such refusal is likely to lead to death.
This right to refuse medical treatment has been recognized by the U.S. Supreme Court as being constitutionally guaranteed as a matter of privacy. This right is protected, also, under the First Amendment when religious beliefs are involved. It has often been exercised in the refusal of blood transfusion, for example. This right to refuse treatment may be properly considered one of our “inalienable rights” inasmuch as the courts have protected it without there being specific statutes declaring it. This right has been superseded only when courts have judged that some other competing right should be given priority.
Legislation is constantly being proposed where patients should put into writing their wishes to refuse medical treatment under some circumstances. Such legislation and laws are ill-advised. It is potentially dangerous to the individual; it is potentially dangerous to society. It is unnecessary.
There is danger to the individual who would write a “living will” under the influence of such legislation. Necessarily, the living will must be written in advance of the time when it may actually be exercised in a decision to withhold treatment. But at the time of writing a “living will” the patient has no way of foreseeing all the specific details of what his condition might be when some other person may decide to apply the provisions of the document when the patient, were he able to reflect and to express himself, would not apply them. Such a person, who may be serving interest other than those of the patient, would be free to sacrifice the patient to the benefit of such other interest, and in doing so enjoy the protection of the law. To illustrate, one example of such other interests would be the desire to obtain organs for transplantation. An exhaustive list of many other medical and no medical interests is not necessary.
The right to refuse medical treatment is indeed a right. Connecting this right to laws passed by the states will change its character. first, it will tend towards giving this right the appearance of being not a right, but a privilege granted by the state. This poses a danger to society. As a privilege granted by the state it could be very easily withheld in selected cases, as may occur with any and all privileges. Thus, individuals could find themselves subjected to medical treatment against their will under the force of law. This happens in the psycho-prisons of the Soviet Union. It came close to happening in the United States in a case dealing with bone marrow transplantation. Further, when the acceptability of withholding medical treatment is codified into law as permissible and ethical at the discretion of an individual, there remains only one small step for the state to declare as mandatory, at its discretion, that which is already accepted as ethical and permissible at the discretion of an individual.
In summary, the right to refuse medical treatment is a right individuals enjoy, long recognized and protected by our courts. We do not need additional legislation to enhance a right that is so established. At best, such laws are merely redundant. But, at worst, they pose a genuine threat to destroy not only the right they claim to protect, i.e. the right to refuse treatment, but also they threaten in a circuitous way the right to obtain treatment. It is prudent to leave unnecessary laws unpassed.
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