Monday, August 22, 2016
Wendy Metcalf Anderson recently published an Article entitled, A Good Death: Increasing the Adoption and Effectiveness of Advance Directives in Arizona, 8 Ariz. Summit L. Rev. 447 (2016). Provided below is a summary of the Article:
Advance planning for an end-of-life situation can be an effective way to ensure that we live our final days on our own terms. Advance directives, in various formats, outline the patient's desired treatment options, expressed when he is competent to make such decisions, and would be effective in the event that he loses the capacity to adequately communicate or participate in decisions regarding his own care. Dying patients who have discussed their end-of-life wishes with their physician are more likely to choose fewer life-sustaining treatments and more likely to spend their final days in hospice, rather than a hospital, than those who have not engaged in this type of conversation.
Americans, however, generally do not die in a way they would like. Overall, patients and their families have expressed the desire for quality of life and to avoid artificially prolonging their dying process. While the majority of Americans would prefer to die at home or at hospice with less aggressive care, studies have shown that seventy-five percent die in a hospital or nursing home, with nearly twenty percent of them in the intensive care unit. As a result, chronically ill and dying Americans are receiving medical care far in excess of what they and their families want. Yet fewer than twenty-five percent of Americans have executed advance directive documents that clearly specify their wishes.
This paper will discuss various advance directives currently in use and the landmark legal cases that created national awareness and debate over the last 40 years. Additionally, this paper will consider the current state of legislation regarding advance directives nationally and in Arizona and will explore the reasons that the laws inadequately serve to better encourage the use and effectiveness of these documents. As its primary purpose, this paper will propose several statutory changes designed to increase the rate of adoption of advance directives in Arizona and improve the availability of such documents when they are needed most - when a patient is physically or mentally incapable of communicating their end-of-life wishes.