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Gaceta Sanitaria

Print version ISSN 0213-9111


NEBOT, Cristina; ORTEGA, Blas; MIRA, José Joaquín  and  ORTIZ, Lidia. Dying with dignity: A study of living wills. Gac Sanit [online]. 2010, vol.24, n.6, pp.437-445. ISSN 0213-9111.

Objective: To describe the profile of persons who exercise their right to draw up a living will, to analyze physicians´ knowledge of living wills and attitudes toward them, and to compare the regulations pertaining to this right in the distinct autonomous regions of Spain. Method: A descriptive study that included an analysis of a systematic sample of 931 living wills registered in the autonomous region of Valencia (Spain), a self-administered structured questionnaire administered to a sample of 84 physicians working in emergency departments and intensive care units (45% response rate), and a comparison of the regional legislation covering living wills. Results: A total of 1.6% of inhabitants aged 16 or over had registered a living will (female/male ratio: 1.8/1). Most (73.8%) used a standard document drawn up by a particular religious faith. The most common reasons for writing a living will were to limit therapeutic efforts (99%) and obtain pain-relieving drugs (98%). Although 61 physicians (72.6%) frequently attended the terminally ill, only 6% consulted the register of living wills in these situations and 28% did not know how to consult this register. There is wide variation among regions in the minimum age for registering a living will, in the procedure to be followed if the signer is pregnant, in designating a person as having the authority to make a living will, and in the number of registration points available to deposit livingwills. Conclusions: Most persons registering a living will are healthy individuals with a particular religious faith who reject certain treatments. Most health professionals do not check whether critically ill patients have made a living will. Exercising the rights contained in living wills is complicated by the diversity of criteria among different regions.

Keywords : Living will; Patient rights; Physician attitudes.

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