Living Wills and Advanced Directives Term Paper

The overall incidence of the withdrawal of life sustaining measures in European ICUs is not known, although withholding and withdrawing life support is actively used by most European intensivists, shortening of the dying process remains rare. In the treatment of terminally ill patients in Japan, new surveys indicate that Japanese physicians tend to treat the patients more aggressively. An analysis showed that in Japan, patients wishes are often not taken into account while a greater weight is placed on the feelings of the family. The overall feeling in Japan is that to withdraw or withhold treatment is essentially to abandon the patient and heroic measures are usually undertaken in an attempt to prolong the patient's life until family members are present at the bedside to witness the time of death. The physicians in Japan who were interviewed regarding end of life care still seemed to feel that withdrawing or withholding any life sustaining treatment would be considered ethically or legally unacceptable.It is also important to take into account that medical costs in Japan may not be a consideration in end of life care. The Japanese health care system is such that all care to those over age 70 (or over age 65 and bedridden) is free, therefore the financial burden associated with terminal care common in Western counties will not be an issue to families of the terminally ill in Japan. There has been a trend noted toward over treatment of the elderly, although no specific data has been found which suggests any financial association with the provision or withholding of life sustaining care by Japanese physicians.

Although a good portion of the advances in health care made during.....