Living wills are bad predictors of post-injury wishes

Nevertheless, a recent article in 'Brain Injury' injects a note of caution by suggesting that people may be prepared to suffer a far greater degree of disability than they might have imagined in advance.

In this article, Tom McMillan, Professor of Clinical Neuropsychology at the University of Glasgow, points out that Living Wills may represent the wishes of the person when able-bodied, but may not allow for the changes of mind that the person is very liable to undergo when injured.

He has detailed knowledge from his own clinical experience and from case reports of able-bodied people who sustained immense physical and brain injuries and yet who persisted in wishing to live, despite feeling suicidal at times, suffering pain and having become totally dependent on others - and despite in some cases having previously expressed a desire not to be kept alive in such a situation.

In his view, decisions such as the removal of artificial feeding should be made by the courts and should take into account not only the living will but also the views of the doctor, family, guardian and any expert opinion.

In the meantime, the position in the UK remains that an appropriately drafted living will (also known as an advance directive) is legally binding in common law.