Question: I have a brother who is 95 years old. He has been in a nursing home for years now, and he made a living will a while ago, but despite this, the nurses keep giving him antibiotics to keep him going.
He says he wants to die but, even though he had pneumonia recently, they insisted on medicating him to get well. The nurses just say they have to do this, but is there anything we can do to help him on his way - just by withdrawing treatment next time he gets ill? He has told me he is longing to die, and I feel so sorry for him.
Answer: The problem with “living wills” (or Advance Decisions, as they are now known) is that they are couched in variable terms, and some forms are better than others. And anyway, they need to be regularly re-signed at least every three to four years. Very few people are aware of this - they sign them and then forget them, thinking that now they've addressed the grisly issue, it's all fine and they don't have to go there again. But that's no good. Doctors who, for religious reasons, want to keep patients alive can, if the living wills are too old, often ignore them. But they are legally binding if up to date.
The problem with nurses is not just that they fear for their jobs if they don't keep pushing sustenance and medication down people's throats - and also that some may have religious beliefs that put them at odds with withdrawing treatment - but they also, perhaps because they're not yet old enough, may have no concept that anyone, even someone of your brother's age, could actually be in a position to accept death as a natural part of life.
An elderly friend of mine, who had signed a living will and had constantly told people of her desire to die after a certain point, was woken every two hours when she was dying by nurses eager to feed her soup and water, despite her daughters telling them that she didn't want anything and she was ready to go.
But the strongest way of ensuring that treatment is withdrawn is to have a Lasting Power of Attorney, which would give someone your brother trusts, such as you, the legal authority to make decisions on his behalf. They are more effective but far more expensive, as they involve a lawyer and have to be endorsed by a court.
Still, in principle, with a Lasting Power of Attorney, if a doctor doesn't follow the guidelines then he can be taken to court himself for not doing the right thing.
I'm slightly surprised, though, that your brother doesn't simply refuse to take the pills. It is unlikely that anyone could force him to take them, though I agree that if he is ill it might be difficult to put up resistance. But surely you are around and can explain your brother's feelings to the people concerned? And perhaps get other members of his family involved?
Anyway, if that's not possible, then there is no reason why your brother, once he has recovered from his most recent illness, can't, at this stage, summon his solicitor and get a new Advanced Decision drawn up, or a Lasting Power of Attorney, and make a new request to have his treatment withdrawn at a certain point - assuming that he is perfectly sane.The Independent