Because I Like it Here: Living Wills and Change of Attitude

Publication year1998
Pages125
27 Colo.Law. 125
Colorado Lawyer
1998.

1998, June, Pg. 125. Because I Like it Here: Living Wills and Change of Attitude




125


Vol. 27, No. 6, Pg. 125

The Colorado Lawyer
June 1998
Vol. 27, No. 6 [Page 125]

Specialty Law Columns
Estate and Trust Forum
"Because I Like it Here": Living Wills and Change of Attitude
by Clifton B. Kruse, Jr

A frail elder, in his late eighties, dying of kidney disease and cancer, was recently disengaged from life-support technology. His living will required this step forty-eight hours after he was diagnosed as terminally ill, provided that he was also in an unconscious state. These preconditions had been satisfied

Regaining consciousness following the removal of life-support, and after leaving the hospital and returning to his bed at his group home, he responded to the question "Do you still want your living will enforced if a similar crisis occurs?" with an unmistakable and emphatic, "No!" "Why?" his lawyer asked. He responded, "Because I like it here."1

Limited as he was to a bedridden state, with one useless kidney and one cancerous companion that dutifully tried, but at best inadequately, to remove his nitrogenous wastes, a significantly restricted life was better, he felt, than none at all. He lived courageously and continued to find entertainment in his limited habitation. However, he had executed a living will when he was young, more healthy, and vertical in posture. He could not at that earlier time imagine wanting to live a life of significantly lesser joy.

A History of Medical Advances

When Hippocrates was born, about 460 B.C.E.,2 illness was believed caused by supernatural forces. Ancient theurgy held that divine agency was necessary in the cure of disease.3 Hippocrates, well known for the physician's oath,4 introduced a medical theory about illness that was founded upon empericism.5 He believed that cure for disease was both natural and discoverable, determined by cause and effect, and had nothing to do with the supernatural nor with magic.6

Notwithstanding this beginning and the prescient insight of this early physician, it was not until the Sixteenth Century, about 2,000 years after Hippocrates' death, that the workings of the internal anatomical structures of human beings were known.7 William Harvey proved by demonstration in the year 1616 that the human heart did not contain "innate heat,"8 but was a mechanical device that pumped blood through the body in a continuous circuit. Not until that time did our medical pioneers understand the function of the heart, what is now unquestioned and comprehensible to us.9

More than two millennia have passed since empirical medicine was first recognized. Important medical innovations have followed, including improvement in the diagnosis of illness, the realization that unseen germs cause sickness and death, the discovery that cells are the basic units where disease begins, the compounding of helpful medicines and anodynes, surgery without pain, and organ transplantation, for example, but by 1900 there still remained few effective treatments for life-threatening diseases.10

Surgeons still operated in frock coats stiff with blood and filth in the last century, and asepsis, disinfecting the operating area, and antisepsis, sterilizing the wound area itself, was not common until 100 years ago.11

Major advances in life-sustaining technology did not begin until the 1920s, only seventy-five years ago. Insulin was discovered in 1921, making treatment for diabetes possible. Ten years later, the first mechanical ventilator, the "iron lung," was invented, and sulfa drugs and penicillin, preventing the growth of disease-causing bacteria, were discovered and synthesized.

The artificial kidney was crafted during the 1940s, its appearance...

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