Is Your Family's Life at Risk? MOST STATES DON'T REQUIRE DOCTORS TO HONOR ADVANCE DIRECTIVES THAT DIRECT FOOD, FLUIDS, TREATMENT.

The laws of all but 10 states may allow doctors and hospitals to disregard advance directives when they call for treatment, food, or fluids, according to an important report issued by NRLC's Robert Powell Center for Medical Ethics April 15. The shocking conclusion of "Will Your Advance Directive Be Followed?" is that in 40 of the 50 states, there is NO guarantee your wishes will be honored, even if you make them abundantly clear in a valid advance directive!

The Report's results take on added urgency in the wake of the death of Terri Schindler Schiavo. Authorities have urged Americans to complete advance directives, like living wills, to state in which circumstances they would want medical treatment, food, and fluids if they become incapable of making these decisions.

However, the Powell Center report charges that, increasingly, health care providers who consider a patient's "quality of life" too low are defying these directives to deny treatment against patient and family wishes.

Dorothy Timbs, J.D., legislative counsel for the Powell Center for Medical Ethics, told reporters at a press conference at the National Press Club, "We believe most Americans will be deeply disturbed that four-fifths of the states do not clearly protect their right to choose food, fluids, or life-preserving medical treatment." She added. "It is important to fill out an advance directive like the Will to Live available on our web site to make clear your wish not to be denied food or treatment, but it is equally important to work for legal reform so that your choice for life in such a document will be honored."

What few people know is that virtually all states allow health care providers to refuse to follow an advance directive. The key is (1) what treatment you receive while your family is trying to find a facility that will treat you, and (2) what happens if the patient cannot readily find another health care provider. The report from the Powell Center paints a very bleak picture for the medically vulnerable.

Released in mid-April, "Will Your Advance Directive Be Followed?" documents that there are only 10 states that essentially protect a patient's directive for life-preserving measures in situations where the doctor, hospital, or other health care provider disagrees.

The state statutes of 23 states, Guam, and the U.S. Virgin Islands offer no protection. When a patient or his/her family wants life-preserving measures, health care providers can simply refuse to comply. The rationale varies, but it frequently is based on judgments by health care providers that the patient's "quality of life" falls below their view of what makes life worth living.