End of Life issues Presentation and Service

Last night I was at the evening service at St Andrew's Parish Church in Bo'ness where members from churches in the neighbourhood met to listen to a talk on end of life issues by Dr. Murdo Macdonald. Dr Macdonald is the policy officer of the Society, Religion and Technology Project at the Church of Scotland. He presented us with a much needed update of the current legal framework for assisted suicide in Scotland and the differences between the Scottish position and the position in England. His comments were based on the End of Life Issues report to the General Assembly last year.
After the talk, there was the possibility for questions and also prayer as some of the issues talked about were intensily emotional.

The Voluntary Euthanasia view on the Living Will

The VES wishes to make the provisions of a living will binding upon the medical staff involved. They see this as a first step towards fully legaliseing eithanasia and, for the same reason they wish to see a proxy document separately legislated for, as a separate deed from a living will. No Will can 'work' without the appointment of an executor. the appointment if a 'health-care proxy' to be in effect the executor of the living will would greatly assist the effectiveness of such a document.

At present, only the person making the living will has the right to enforce it, and he is by definition incapax (incapable of making valid legal decisions). To give treatment against the expressed wishes of the patient, however, is already assault at common law, and there is therefore nothing to prevent the patient refusing in advance. The wisdom of restricting the judgement of the doctor responsible for care at this sensitive time of life is a matter which would require careful consideration. The style of living will published by the EXIT, the Voluntary Euthanasia Society of Scotland (VESS) proposes the appointment of a tutor dative (an agent appointed by the court) by the Court of Session, but this is a cumbersome and expensive procedure.





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Living Wills

An Advance Directive, is a document in which an individual lays down instructions as to health-care management and treatment to be applied in the event of their incapacity to make such decisions or convey such instructions at the time of occurrence of the circumstances envisaged. In different states in the USA there is some diversity of definition between 'Living Will' documents, 'Advance Directives' and 'health-Care proxy' documents, but the Voluntary Euthanasia Society (VES) in a careful study of the matter perceives no need to impose such distinctions. They suggest that 'Living Will' is a concept sufficiently understood to be generally used.

The Limitations of a Living Will

The popular view that a will is inviolable is not true, even in the case of a property will, and conditions which are contrary to established law or public policy cannot be enforced. This is certainly the case in the Living Will instance, since such a will cannot instist that a doctor or anyone else should put the Will-maker to death.

What do doctors think about Living Wills?
The medical view as expressed by the British Medical Association, is that a Living Will may be welcomed as an opening for the discussion of the difficult questions raised by terminal illness, and considerable use has been made of them in the context of AIDS care and counselling. neither the BMA nor the AIDS support agencies, the Terence Higgins Trust and Milestone House, nor the Association for Palliative Medicinesee any need for legislative change.





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