This article by Wesley Smith forst appeared in the journal, First Things. It relates specifically to the USA but the lessons and observations are universal.It shows the level of suspicion people have for government and the health care system that many of us distrust paying doctors to engage in end-of-life discussions. Indeed, during the run-up to the passage of Obamacare, Sarah Palin labeled a never-passed provision to pay doctors for such conversations, "death panels." That political sound bite struck such a powerful chord that it quickly entered the lexicon. Continue reading

  One of my most popular blog articles of the past few years was a piece I penned called: Autonomy or automatons? (or 'autonomy anomaly'?) in April 2013. In it, I discussed the problem with the possibility that everything contained in a person's advance care directive would be binding upon a treating doctor. I argued that this would remove the doctor's right to his or her own autonomy and recourse to best medical practice and their judgement borne of experience and their training.Recently a US Oncologist, writing in The Journal of Clinical Oncology discusses the issue of autonomy using what must be seen as something of an extreme example. David P. Steensma talks about a patient, who apparently had no faith in conventional medicine and, even in the face of a raging cancer, refused his ministrations towards dealing with the disease through conventional medicine. Continue reading

This is an interesting report by  Alex Schadenberg. It goes over old ground in many respects but does go to show that Advance Directives, even though they can and do provide the opportunity for clarity of intention and choice, can still present difficulties. Continue reading

  From time to time people engage me in conversations about their concerns about Advance Care Directives (ACDs). These concerns generally, but not always, centre around a perceived risk that ACDs might be some backdoor way of effecting wishes for euthanasia.  Continue reading

  Lat Tuesday evening the Legislative Council (Upper House) of the South Australian Parliament finalized the debate on the SA government's Advance Care Directives Bill.  Continue reading

South Australian MP and euthanasia advocate Steph Key MP announced today that she wants to be able to create 'options' in Living Wills for people to be able to choose death. 'Living Wills'- once used to describe what are now known more accurately as 'Advance Care Directives', are instruments where a person can make a determination, in advance, of what type of care they want and/ or reject at the end-of-life. The use of the word 'Living' in this context simply modifies the normal understanding of a Last Will and Testament. Key's use, however, seems to be a deliberate and macabre play between living and dying.Advance Care Directives can be useful instruments. They can also be problematic in situations where the request is poorly worded or does not account for unforeseen circumstances. Regardless, they were never intended to be used for the person to direct that they be killed. Continue reading

  One of our national daily's most senior and respected columnists exposes the problems with South Australia's Advance Care Directives Bill.  Continue reading