You should recall the seven-year long legal case that revolved around whether Terri Schiavo, diagnosed as being in a persistent vegetative state for several years, could be disconnected from life support.  She had no living will expressing her wishes.  Her husband wanted to have her feeding tube removed, but was opposed by her parents.  This private, family affair became a public media circus, which included involvement by many advocacy groups and politicians.  Well over 5 different lawsuits and 14 appeals were filed before the Pinellas County Circuit Court’s decision to disconnect Schiavo from life support was carried out on March 18, 2005.  This case highlighted the importance of everyone having a living will, to specify and document your end-of-life wishes. 

A recent article in The Florida Times-Union, which is linked here, http://jacksonville.com/news/metro/2010-04-04/story/rule-prompts-balance-medical-moral-issues provides a reminder of the importance of having, not just a “form” living will, but one which gives very specific instructions.  According to the article, St. Vincent’s HealthCare, which manages St. Vincent’s and St. Luke’s Hospitals in Jacksonville, has issued a directive to its hospitals stating that there is a “general moral obligation to provide food and water to patients, including those in a persistent vegetative state.”  The author of the article noted that this directive may be in conflict with patients who state in a living will that they do not wish to be kept alive by artificial means. 

Considering this directive, you may wish to revisit your living will to make certain that you have indicated very specifically whether or not you wish to receive food and water by artificial means if you are hospitalized with a terminal, or end stage condition, or if you are hospitalized in a persistent vegetative state.  If your living will contains only general language and does not specifically reference the application of food and water in your situation, then if you are hospitalized at St. Vincent’s or St. Luke’s Hospital in Jacksonville (according to this newspaper article), those hospitals will choose to provide you with food and water even by artificial means.  Your designated health care surrogate may not be able to persuade them to disconnect a feeding tube, for example, because any wishes you may have had to the contrary were not expressed clearly enough to overcome this directive.  Of course, if you have no living will at all, and find yourself in such circumstances, you likely will be subject to this directive.  Whatever your religious beliefs, this is a subject that you not only should carefully think about, but also act upon.