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Legislation has been introduced that would give a tax credit for 30% of legal costs incurred, maximum $500, for the legal expenses incurred in filling out an advance health care directive (HR 2705). The hope, I am sure, is that people will eschew extensive efforts to save themselves, and thereby, preserve health care resources. 

I believe in advance directives, but I think people should make careful and informed decisions about what care they would not want—and be able to decide that they want their lives saved—a “choice” explicitly threatened by Futile Care Theory.

As for the bill, I am relatively indifferent. I don’t think it will induce a lot of people to go to a lawyer and create an advance directive.  Most who fail to create directives don’t do so out of discomfort about thinking of their own mortality and potential debilitation, not out of worry about the legal costs. This is short sighted because the best time to fill out these legal documents is when there is time to think hard about the choices, not when entering a hospital or in a crisis. (For anyone interested, the International Euthanasia Task Force on Euthanasia and Assisted Suicide offers for a very modest fee, a state-specific advance advance directive called the Protective Medical Decision Document, or PMDD, a durable power of attorney-type document in which the signer rejects euthanasia and dehydration.)

Here’s a deal: We pass the bill and outlaw Futile Care Theory at the same time. That would be a real win-win.


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