[Dying with dignity. A study of living wills].
OBJECTIVE
To describe the profile of persons who exercise their right to draw up a living will, to analyze physicians' knowledge of living wills and attitudes toward them, and to compare the regulations pertaining to this right in the distinct autonomous regions of Spain.


METHODS
A descriptive study that included an analysis of a systematic sample of 931 living wills registered in the autonomous region of Valencia (Spain), a self-administered structured questionnaire administered to a sample of 84 physicians working in emergency departments and intensive care units (45% response rate), and a comparison of the regional legislation covering living wills.


RESULTS
A total of 1.6% of inhabitants aged 16 or over had registered a living will (female/male ratio: 1.8/1). Most (73.8%) used a standard document drawn up by a particular religious faith. The most common reasons for writing a living will were to limit therapeutic efforts (99%) and obtain pain-relieving drugs (98%). Although 61 physicians (72.6%) frequently attended the terminally ill, only 6% consulted the register of living wills in these situations and 28% did not know how to consult this register. There is wide variation among regions in the minimum age for registering a living will, in the procedure to be followed if the signer is pregnant, in designating a person as having the authority to make a living will, and in the number of registration points available to deposit living wills.


CONCLUSIONS
Most persons registering a living will are healthy individuals with a particular religious faith who reject certain treatments. Most health professionals do not check whether critically ill patients have made a living will. Exercising the rights contained in living wills is complicated by the diversity of criteria among different regions.
Dirección General de Calidad y Atención al Paciente, Consellería de Sanitat, Valencia, España. Nebot_cri@gva.es
Cristina
C
Nebot
Blas
B
Ortega
José Joaquín
JJ
Mira
Lidia
L
Ortiz
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016224:Living Wills; D008297:Male; D008875:Middle Aged; D010820:Physicians; D012297:Right to Die; D013030:Spain; D011795:Surveys and Questionnaires; D055815:Young Adult