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Terri Schiavo's controversial death is old news now, but many of us are still grappling with the end-of-life questions it made us ask. The Florida woman's case propelled millions to consider living wills.

Not so fast, caution many Christian ethicists and right-to-life groups. Living wills are more complex than they appear and alone don't necessarily guarantee death on your terms. Even if you already have a living will, you might want to know why some critics think these documents may be dangerous and others see potential ethical problems. You may not want what you signed.

Some critics go so far as to see the recent rush to sign living wills as a victory of the pro-euthanasia movement.

Flip Benham, director of Operation Rescue, lamented that the Hemlock Society had to be "dancing with glee" as, during the Schiavo debacle, Christian leaders were telling us to have living wills drawn up. Want it from the horse's mouth?

"We have to go stage by stage, with the living will, with the power of attorney, with the withdrawal of this; we have to go stage by stage," said Derek Humphry, founder of the Hemlock Society (now called End-of-Life Choices), in a 1986 interview quoted in National Right to Life News. "Your side would call that the 'slippery slope.' We would say, 'Proceed with caution, learning as we go how to handle this very sensitive situation.'" Pro-lifers also point out that the first living will was devised by the Euthanasia Society (now called Choice in Dying), and the documents are routinely advocated by groups that lobby for direct euthanasia.

Just because such groups favor living wills doesn't negate their value. But it does suggest that they can be used, even inadvertently, to promote values that contradict Scripture.

Another reason for being cautious about living wills is that they're fixed in time. Advancing medical technologies generate new ethical questions and options. Some fear living wills will lead to undertreatment. Others point to the fact that we change our minds. Views on treatment made when we're healthy can change when we're not. Perhaps some of the biggest problems are limitations our own words can impose in ways we don't intend. Another criticism is the patient's insufficient medical knowledge of illnesses and treatments and inadequate or superficial thought given to making advance life-and-death decisions.

Whatever your end-of-life decisions are, know there's more than one way to see they're carried out.

Advance directives are documents indicating what medical care you want or don't want if you are ever incapacitated. The directives include the living will, the durable power of attorney for health care (or health care proxy), and hybrid documents that combine the two.

A living will, the oldest type of advance directive, is a legally binding document stating what health care you want or don't want if your death is imminent. The power of attorney designates who you want making your health-care decisions if you can't. The many combination documents name your surrogate and list your wishes.

When considering your philosophies, Carrie Gordon Earll, senior policy analyst for bioethics for Focus on the Family, offers this suggestion: Cross-reference (1) various kinds of life support (tube feeding, ventilators, antibiotics, CPR, etc.); (2) various diagnoses (disabled, brain damaged, PVS, coma, minimally conscious, actively dying); and (3) various prognoses (death imminent, recovery unexpected or unknown, etc.).

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August 2005, Vol. 49, No. 8