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Susan Nobel, CSW; Judith C. Ahronheim, MD
Society for the Right to Die New York, NY

JAMA. 1990;263(8):1069.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

Drs Emanuel and Emanuel¹ have proposed a new medical directive that attempts to combine all aspects of terminal care in a single document. The Medical Directive has been proposed as an answer to limitations of the living will. The authors cite the rarity with which the living will is used in clinical practice, potential vagueness in terminology that could lead to problems of interpretation, and the fact that many patients sign living wills without involving their physicians. The proposed medical directive certainly goes some distance to ensure specificity in the signer's instructions, but it is difficult to see how such a document would solve the major problem—that the majority of people today simply do not make advance provision for health care decision making. If anything, the complexity of the proposed replacement could further discourage wide use.

Our experience as a patient advocacy organization confirms the fact . . . [Full Text PDF of this Article]

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