f that concept through the use of a living will. Medical education and socialization focus on offering and providing treatment, as opposed to the facilitation of death (Dubler, 1993, pp. 23 25). Thus, the very idea of a right to die or the right to refuse care is difficult for many health care providers to accept, much less become an advocate for a patient in such circumstances. Nurses, however, are increasingly being asked and expected to assume such advocacy roles (Bellocq, 1988, pp. 168 175). The relentless advance of medical technology assures that the pressures on health care providers will continue, as the means to maintain biologic life far surpass the health care professional's ability to protect the quality of a patient's life (Allen, 1991, pp. 150 151).
The decisions of health care professionals to permit death are amalgams of medical, ethical, and legal judgments (Dubler, 1993, pp. 23 25). While the nominal responsibility for such decisions is that of physicians, other health care professionals and members of hospital establishments contribute to such decisions. The nurse, with a traditional role that is patient centered, must counsel the patient and the patient's family, and where required become an advocate for the patient. Hospital administrators and legal counsel, by contrast, out of fear of an exposure to legal liability typically attempt to limit the rights of patients and their families. What these ostriches cannot see from their disadvantaged perspectives is that in the evolving contemporary society a refusal to accommodate patient rights in itself will expose health care institutions and providers to legal liability.
In the wake of the 1990 Supreme Court decision allowing the discontinuance of life support for Nancy Curzon, health care providers are being forced to reconsider their positions toward patient right and family rights generally and to living wills particularly (Keyser, 1992, pp. 37 49). Liv...