Experts Criticize Missouri's `Living Will' Law

Article excerpt

Experts say Missouri's "living will" law is probably the nation's most restrictive.

In fact, some lawyers in Missouri advise their clients to use other types of documents to clarify their wishes about life-prolonging treatments.

"Missouri and, to a lesser extent, New York are the two states that lie outside of the national norm" on living wills, says Alexander M. Capron, a professor of law and medicine at the University of Southern California. He is an authority on living wills, or directives that people draw up for their health care when they may not be able to comprehend treatment options.

Alan Meisel, director of the Center for Medical Ethics in Pittsburgh, also called Missouri's living-will law "unusually restrictive" and unclear about the conditions under which feeding tubes and similar treatments can be avoided or removed.

Several lawyers and experts on medical ethics in Missouri said people can get around the law's limitations by such options as the state's "durable power of attorney" law. It allows people to name someone to carry out their final wishes on health care if they become permanently incapacitated. "I don't advise my clients here to use living wills," said Christopher M. Barclay, a lawyer with Herzog, Crebs & McGhee in St. Louis. He recommends that clients with special wishes execute a durable power of attorney for health care.

That's because Missouri's Durable Power of Attorney Act allows people - by adding specific instructions in their power-of-attorney document - to assign someone to authorize a health care provider to "withhold or withdraw artificially supplied nutrition and hydration," if the patient becomes permanently incapacitated.

Experts say the state's living-will law, which was enacted in the mid-1980s, is poorly written and confusing about the conditions under which doctors can legally follow a patient's instructions about withholding or withdrawing feeding tubes or similar life-prolonging treatments.

Sheryl Feutz-Harter, a lawyer in Kansas City who specializes in health care law, called Missouri's living-will law "worthless. …