Living Will

I have studiously avoided using Big Picture to comment on the Schiavo affair debacle. Instead, why don’t I just point to an ABA site that has everything you need to make a living will.

That is all . . .

ABA Commission on Law and Aging
Consumer’s Tool Kit for Health Care Advance Planning

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  1. anne commented on Apr 2

    Public Health Measures Always Involve Trade-Offs

    IN extraordinary circumstances like this,’ President Bush said of the Terri Schiavo predicament, ‘it is wisest to always err on the side of life.’

    Uwe E. Reinhardt, a Princeton University health economist, said that from his perspective President Bush was not quite right: the president should have said ‘err on the side of life years.’

    There are two reasons for this distinction. First, no action can save a life indefinitely; life can only be extended. Saving the life of an infant leads to more expected life years than saving the life of a centenarian.

    Second, health economists are typically concerned with finding policies that maximize the total number of life years, or, equivalently, the average life expectancy of the population, leaving aside quality-of-life issues for now. A focus on life years recognizes that there are inevitable trade-offs involved in health and safety policies.

    One can believe that life is sacred and still recognize that trade-offs exist. If government policy always erred on the side of life, the speed limit would be reduced to 5 miles per hour to eliminate all fatal accidents. Of course, voters would not stand for a 5 m.p.h. speed limit, so at least implicitly policy makers recognize that there is a trade-off between risk and the time required to transport goods and people on the highways.

    This principle was clearly stated by the Office of Management and Budget in the 2003 budget: ‘Since the nation does not possess enough resources to eliminate all risks, an important performance goal for government is to deploy risk-management resources in a way that achieves the greatest public health improvement for the resources available.’

    Yet research indicates that the government generally does a poor job in choosing policies that maximize life years. Many programs are intended to reduce the risk of premature death. If the government used its limited budget to maximize the number of life years, the cost of saving an additional life year would be the same across different programs.

    In actuality, the cost per year of life saved varies widely across regulations and programs. Some cost-effective initiatives that would reduce risks are passed over, while others that are more costly and less effective are put in place….

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