'Round-table' ethical debate: Is a suicide note an authoritative 'living will'?

Donald B. Chalfin, Maimonides Medical Center
David Crippen, St. Francis Medical Center Pittsburgh
Cory Franklin, Maimonides Medical Center
David F. Kelly, Duquesne University
Jack K. Kilcullen, Montefiore Medical Center
Stephen Streat, Auckland City Hospital
Robert D. Truog, Children's Hospital Boston
Leslie M. Whetstine, Duquesne University


Living wills are often considered by physicians who are faced with a dying patient. Although popular with the general public, they remain problems of authenticity and authority. It is difficult for the examining physician to know whether the patient understood the terms of the advance directive when they signed it, and whether they still consider it authoritative at the time that it is produced. Also, there is little consensus on what spectrum of instruments constitutes a binding advance directive in real life. Does a 'suicide note' constitute an authentic and authoritative 'living will'? Our panel of authorities considers this problem in a round-table discussion.