Report Casts New Doubt on Living Wills
Tom McMillan, a clinical neuropsychologist at Glasgow University, has devised tests to establish whether people in a persistent vegetative state (PVS) have any level of understanding. Prof. McMillan says that after working with a patient he is able to communicate with them enough to find out if the patient wishes to live or die.
McMillan was asked to determine the awareness level of Ms. X, a patient doctors believed was at or just above the PVS level. He found that she could press a buzzer with her knuckles, and he devised a series of questions, with yes or no answers, that established her level of understanding and her will to live. Prof. McMillan feels that an assessment of any patient in a similar condition and where the will to live is in doubt should be mandatory. McMillan say his work with the patient shows the danger of living wills in that most people, when making a living will statement, say they would prefer to die if incapacitated. "But once somebody is disabled, their point of view can be completely different. Their interests and motivations have become very different," he said.
Ms. X's family had assumed she would not want to live in this condition due to comments she had made before her accident and had applied to the courts to withdraw feeding. "The weight of medical opinion in this case was that feeding should be terminated," said Prof. McMillan.
His first assessment of Ms. X was published in the journal Brain Injury in 1996. Prof. McMillan has now re-assessed his patient and found significant improvements in her abilities, even though her quality of life to most people would appear very poor. Despite this, "it is of note that she continues to state that she wishes to continue living," he said.
[2/17/00 - The Guardian]
Beginnings, May/June 2000
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