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Dr Rosner correctly points out that there are complex ethical issues involving the use of a living will. The two case examples in the article were selected to highlight both the benefits and liabilities of the living will in clinical settings.In contrast to what Dr Rosner suggests, however, most forms of the living will allow for patients to have ready control over rescinding the living will. The California Natural Death Act, eg, allows patients to deactivate the will by oral or written communications. The primary intent is to maximize patient autonomy rather than lock the patient into an irrevocable position. As stated in the article, physicians who differ with the patient's judgments because of their own religious convictions or personal ethics have the obligation to inform the patient of this fact and make an appropriate referral.The living will is an attempt to provide persons with the
Eisendrath SJ, Jonsen AR. The Living Will-Reply. JAMA. 1983;250(20):2789. doi:10.1001/jama.1983.03340200023011