New Scientist - USA (2019-07-13)

(Antfer) #1
13 July 2019 | New Scientist | 21

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Y THE time you read this,
Vincent Lambert may
well be dead. He has been
in a vegetative state since a car
crash in 2008. In a twilight zone
between life and death, he has
been unable to talk, eat or respond
meaningfully to others. Last week,
doctors in Reims, France, began
to remove his life support
following a ruling from the
Court of Cassation, the country’s
highest appeals court.
It followed a six-year legal battle
between two sides of Lambert’s
family – his wife and six brothers
and sisters, who sought to let
him die, and his parents and
two other siblings, who wanted
JOShim to continue to live. The case


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Comment


Clare Wilson is a medicine
and health reporter for
New Scientist. Follow her
on Twitter @ClareWilsonMed

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brought interventions from
politicians, the Pope and the
United Nations Committee on the
Rights of Persons with Disabilities.
Whatever our views on this
case, most of us would think it
is sad that Lambert’s family,
who presumably all care deeply
about him, have been fighting
over his fate in court.
The problem is that few
of us like talking about death,
so few of us take an important
step to ensure that our loved ones
know how we wish to be treated at
the end of our lives – in situations
such as this and in far more
common ones.
That step is to make a living will,
or advance decision, a document

that sets out your medical
preferences if you are unable to
communicate. In the UK, groups
such as Compassion in Dying and
Advance Decisions Assistance
provide free templates online
and advise on how to help make
sure these documents don’t get
ignored when they are needed.
In the US, the National Institute
on Aging website provides advice.
Many people would want all
the medical treatments available
to be thrown at them if they were
unable to communicate their
wishes, and worry that medical
staff will give up too soon. It is
their right to express that wish.
But talk frankly to doctors
and they will tell you the bigger

problem is the opposite: of
overtreatment and inappropriate
medical care that makes death
more unpleasant and prolonged.
It can be just as important to state
clearly in what situations you
wish to avoid certain treatments.
For example, sometimes
people in hospital who are dying
and have stopped eating and
drinking as their body shuts down
will have a feeding tube placed
through their nose, causing
distress and discomfort. Often
families pressure staff to do this
because they can’t accept how
close their relative is to death.
Then there are people who
aren’t dying, but who have very
poor quality of life because
of severe Alzheimer’s disease,
for instance. Would you want to
continue living in that situation?
While assisted dying is illegal
in the UK, as in most countries,
it is legal to refrain from treating
infections such as pneumonia,
to let people die naturally. This
used to be more common, but
is often now resisted by relatives
or care-home nurses.
Some people object strongly
to such a course, while others see
it as being sensible and humane.
The range of opinion is the crux
of this matter. Unless you make
a living will, it won’t be you who
decides what happens to you at
the end. It will be someone else. ❚

Make a living will


For our own sakes, and for those we leave behind, we all need
to think about how we want to die, says Clare Wilson
Free download pdf