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What Living Wills Won't Do: The limits of autonomy

Eric Cohen

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In the aftermath of the Terri Schiavo case, it seems clear that most Americans are uncomfortable at the prospect of politicians' intervening in family decisions about life and death. This is not only understandable, but usually wise. Americans understand that eventually they will have to make medical decisions for loved ones, and that such decisions are wrenching. Most people have little faith that the state--or the courts--can make better judgments than they can. And they are usually right.

But it is precisely the complexity of these life-and-death decisions that sometimes makes state involvement inevitable. The state was involved in the Schiavo case long before Congress intervened, from the time Terri's parents went to court in Florida to challenge her husband's fitness as a guardian back in 1993. State judiciaries must decide when family members clash, or when doctors and families disagree, or when surrogates wish to override a loved one's living will. And state legislatures have a responsibility to set the parameters for judicial decisions in particular cases. They must decide the admissibility of casual conversations in determining a person's prior wishes, or the appropriate weight to give a person's desires (such as requests for assisted suicide) even when they are clearly expressed.

For decades, we have deluded ourselves into believing that living wills would solve our caregiving problems; that healthy individuals could provide advance instructions for what to do if they became incompetent; that such a system would ensure that no one is mistreated and that everyone defines the meaning of life for himself until the very end. But it is now clear that living wills have failed, both practically and morally.

Read the entire article on the Weekly Standard website (new window will open).

Posted: 12-Apr-05



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