2. Introdution >>
1. Executive Summary

Making personal choices is basic to our sense of identity and well being. This is especially true of decisions about our health, our personal care and our safety. If illness or an accident prevents you from making decisions about things that really matter to you, who will make these decisions for you? How will you make your preferences known? This workbook is designed to help you state your preferences if you are in a critical medical situation and unable to speak for yourself. Most importantly, it can help you declare that living with a disability is still living, and that you want rights to the same quality of medical care as persons without disabilities. If you are a person with a disability, this tool can help you think about and state why living with a disability is still living! Access to quality of medical care is therefore essential.

The Manitoba League of Persons with Disabilities has a long-standing involvement in dealing with end-of-life issues, particularly when they concern people with disabilities. The League has undertaken research exploring legal, policy and societal perspectives of the placement of DNR Orders and their impact on persons with disabilities. The first phase of this research was presented to the MLPD membership in October, 2000. It was here that the concept of a “Will to Live” was recommended as one way to help people specify to healthcare providers the level and type of care they would want in critical medical circumstances.

The law in Manitoba states it is up to the attending physician alone to decide whether or not a person can receive life-sustaining treatment. This involves resuscitative measures, but also includes such basic healthcare as the administering of antibiotics and hydration. Furthermore, a doctor can place a DNR Order on a patient’s chart without informing the patient or the patient’s family/support circle. Consent on the part of the patient is not required in order to withhold medical treatment. According to the Manitoba Court of Appeal:

The Court holds it is for the doctor to determine whether or not heroic measures are to be used to maintain the life of a patient in an irreversible condition. Neither consent nor a court order in lieu is required for a medical doctor to issues a non-resuscitation direction… The wishes of the patient’s family or guardians should be taken into account, but neither their consent nor the approval of the courts is required.[1]

A Will to Live was suggested as a way of giving voice to people with disabilities concerning some prevailing medical assumptions that it is better to be dead than to live with a disability. It also provides an opportunity for people to express appreciation for the value of life. People can articulate and reinforce their convictions that life, despite some limited capacities, is still worth living!

Included in this workbook is:

	A brief history of MLPD’s involvement with end-of-life issues faced by people with disabilities;
	Some preparatory materials that help persons begin completing a Will to Live;
	Questions to help develop a Life Statement;
	A guide to help formulate a list of preferences concerning medical actions, personal care, and support; and,
	An Advance Healthcare Directive from the Government of Manitoba.

Along the way are tips that aid in the development of communication skills, self-assertion, and choosing a substitute decision-maker. Within the Appendices are copies available for each person’s physician, substitute decision-maker and designated other person(s).

These are complicated and serious ideas to contemplate. It is our hope that this workbook will ease the task of creating a Will to Live, and will empower each user to make their voice heard in critical healthcare situations.

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1	As cited in the Dominion Law Reports (1997), 154 DLR (4th) 409.

2. Introdution >>


Making A Will To Live - Contents