Abstract

Withdrawal and limitation of life support in the intensive care unit is common, although how this decision is reached can be varied and arbitrary. Inevitably, the patient is unable to participate in this discussion because their capacity is limited by the nature of the illness and the effects of its treatment. Physicians often discuss these decisions with relatives in an attempt to respect the patient's wishes despite evidence suggesting that the relatives may not correctly reflect the patient's desires. Advance decisions, commonly known as 'Living Wills', have been proposed in developed countries as a way of facilitating the maintenance of an individual's autonomy when they become incapacitated. Others have argued that legalizing advance decisions is euthanasia by the back door. Some other persons, including my humble self disagree with this submission. A Living Will is not an instrument of euthanasia, but a request in advance to doctors not to give certain medical treatments. In fact, a Living Will, need not block treatment, but could specify that doctors must continue treatment until the patient is dead, regardless of pain or suffering. In October 2007 in England and Wales, advance decisions became legally binding as part of the 2005 Mental Capacity Act . This has been the case in the USA for many years. The purpose of the present review is to examine the concept of Living Will vis-a-vis Nigerian laws with a view to determining the practicability of same in our jurisdiction.

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