Oncology patients and the living will

The Patient Self-Determination Act now requires hospitals, nursing homes, and health maintenance organizations to ask patients if they have executed and are in possession of a living will. This article provides a brief historical perspective of what living wills are, how patient autonomy has contributed to their existence, and what distinguishes a living will from a durable power of attorney for health care. Included are working examples of these advance directives and a description of the University of Kansas Cancer Unit's positive experience with living wills. The final section discusses the meaning of certain pivotal terms, looks at the current under-utilization of living wills, and closes with an examination of the Blackhall thesis of futility.