Living wills are often touted as a sure-fire way to ensure that our end-of-life wishes are observed. A living will is a legal document designed to relate wishes in the event that the individual becomes seriously ill and unable to communicate. This document often includes specific information about the type of treatment, care and interventions that a person does or does not want to have if he or she becomes terminally ill.
Do living wills accurately convey end of life decisions? According to new research published in the APA journal Health Psychology, these directives may not be as effective as many believe because preferences can change over time without the individual being aware of these changes.
"Living wills are a noble idea and can often be very helpful in decisions that must be made near the end of life," explains Peter Ditto of the University of California-Irvine. "But the notion that you can just fill out a document and all your troubles will be solved, a notion that is frequently reinforced in the popular media, is seriously misguided."
In the study, 401 participants over the age of 65 were asked about which life sustaining treatment they would want, such as CPR and tube feedings, if they were seriously ill. Twelve months later, these individuals were asked to recall the choices they had made in the first interview.
Approximately one-third of the respondents had changed their wishes over the course of the year. Surprisingly, 75% of these individuals falsely remembered their original views on various end-of-life treatments. Researchers also interviewed individuals who held the authority to make such decisions in the event that the participants were no longer able. These individuals showed even lower awareness of changes in their loved ones wishes, with 86% of respondents showing false memories.
Ditto suggests that these results indicate that living wills should have an "expiration date." But what should people do in order to ensure that their final wishes are followed. "On a more personal level," Ditto explains, "our research stresses the importance of maintaining an ongoing dialogue among individuals, their families and their physicians about end-of-life treatment options.
Reference: Sharman, S.J., Garry, M., Jacobsen, J.A., Loftus, E.F. and Ditto, P.H. False memories for end-of-life decisions. Health Psychology, 27(2), 291-296.
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