title: Living wills, duty of care and the right to treatment.
abstract: Agnes Simon, a district nurse with 20 years' experience, has been caring for a man with motor neurone disease for the last 5 years. During this time the patient has shown remarkable tenacity but the disease has now progressed to the stage where artificial nutrition and hydration (ANH) is required. A percutaneous endoscopic gastrostomy tube has been inserted through which the patient receives food, water and medication. On her most recent visit the patient gave Agnes a signed and witnessed living will. Unusually, the living will did not indicate the patient's wishes regarding the limitation of treatment. Instead it made clear that the patient wished to continue to receive ANH up to the time of his death. He did not want the care team to withdraw this treatment without his permission, as he feared he would suffer from the indignity of slowly dying from thirst and starvation. Agnes has never seen a living will where a patient demands a right to treatment and wonders whether such a document is lawful and binding on her.
authors.affiliation: Centre for Philosophy, Law and Healthcare, University of Wales-Swansea, Wales, UK. richard.griffith@swan.ac.uk
authors.forename: Richard
authors.initials: R
authors.lastname: Griffith
mesh_terms: D003152:Community Health Nursing / Q000331:legislation & jurisprudence*; D006801:Humans; D016224:Living Wills / Q000331:legislation & jurisprudence*; D016743:Mental Competency / Q000331:legislation & jurisprudence; D010288:Parenteral Nutrition / Q000451:nursing*; D028701:Patient Rights / Q000331:legislation & jurisprudence*; D026684:Personal Autonomy; D016079:Refusal to Treat / Q000331:legislation & jurisprudence; D006113:United Kingdom