Before Dec. 1, doctors had worried that a new law requiring hospitals to discuss with patients the possibility of using artificial life support systems would unduly shock or startle some patients. Few expected David Schulte's reaction.
Mr. Schulte tried to sign a living will right in the Sinai Hospital admissions office after a clerk handed him a packet of information and explained the purpose of it.
"I'm pretty sure it's not going to be needed," said the 50-year-old Baltimore factory worker as he faced heart bypass surgery Tuesday. But, just in case, he wanted his care-givers to know how he felt about being kept alive by a machine: "I want no part of it."
The clerk told Mr. Schulte the living will had to be witnessed and was something he ought to talk over with his family and his doctor, but he was intent on getting it signed before he was wheeled into the operating room. So he enlisted the visitors of a fellow patient to witness the document.
"I think it's almost criminal to keep somebody around who doesn't have much hope of recovery," said Mr. Schulte, who was in fair condition yesterday after his operation.
Although few patients have wanted to sign a living will on the spot, many are showing an interest in documenting their wishes about the use of respirators or other such equipment, according toa dozen hospitals surveyed in the Baltimore area. "Many people are receptive because they've heard or read about it," said Paul Umansky, spokesman for Sinai.
The state attorney general's office has seen requests for living will forms and similar documents skyrocket since the new law went into effect Dec. 1. About 800 people have written or called the office for the forms, provided free of charge, compared to 50 requests in an average week, said Jack Schwartz, chief counsel for opinions and advice.
Marylanders can document their wishes about dying naturally or extending their lives with technology in three ways: The living will states the wishes of a terminally ill patient when death is imminent; the durable power of attorney for health care is broader than a living will and designates a proxy to speak for a patient in all decisions about his care if he can no longer communicate; or a patient can simply discuss his wishes with a doctor and ask the physician to note the discussion in his medical record.
