The purpose of a living will and its importance should not be underestimated, especially if you face an unexpected medical problem. A living will is a legal document that a person uses to make known his or her wishes regarding life-prolonging medical treatments. Living wills have no resemblance to conventional wills or to living trusts. A living will allows you to state specifically which medical treatments you wish to receive or not receive in the event that you are too ill or incompetent to make a decision regarding your medical care. Living wills can also be known as advance directives, health care directives or physicians' directives.
Creating a living will
Each state has its own name and requirements for living wills. Meeting with an estate-planning lawyer can help you set up your living will and determine a health care power of attorney. There are also many Web sites that offer free printable living wills.
A living will describes your wishes regarding life-prolonging treatments. You can determine which medical treatments you do or do not want applied in the event of a terminal illness or permanent vegetative state. A living will does not become effective until you are declared incapacitated or are otherwise unable to make your own medical decisions. Your incapacity or inability to make your own medical decisions will be determined by a physician. Until then, you will be able to say which treatments you do or do not want, even if they differ from what is set forth in your living will. It is also important to note that if you have a heart attack and have a DNR order in your living will, you will be resuscitated. A living will is only used when recovery is deemed hopeless.
In some instances you may be declared incapacitated and unable to speak for yourself, but you are not terminally ill. In this situation your health care power of attorney or health care proxy would be responsible for carrying out your wishes. It is important that your health care proxy be aware of your wishes regarding life-prolonging procedures. Communicating your wishes will help lessen the burden of making heart-wrenching decisions about life and death.
Make your wishes known
Living wills can be as general or as specific as you want them to be. You may indicate your wishes regarding cardiac resuscitation, mechanical resuscitation and artificial nutrition and hydration. It is up to you which types of provisions are contained in your living will. For example, you may state that you and your physician will make health care decisions together, as long as you are of sound mind and possess the ability to make your wishes known. You may state that if there comes a time when you are unable to make medical decisions about yourself because of illness or injury, you want certain treatment preferences to be honored.
For example, you may be suffering from a terminal condition that will lead to your death within six months even with available life-sustaining treatment. You may request that all treatments other than those necessary to keep you comfortable be discontinued or withheld and that your physicians allow you to die as gently as possible. Or you may request that you be kept alive in such a terminal condition using available life-sustaining treatment.
When you're drafting a living will, you may want to have a long talk with your physician about treatment options. Then you can list those that you do and do not want in specific circumstances, such as artificial nutrition and fluids, intravenous antibiotics, etc. Be sure to state specifically if you do or do not want a treatment, and be specific about the circumstances, such as a terminal illness versus a persistent vegetative state.
Choosing a power of attorney
The biggest reason for drafting a living will is to keep you in control of your health-care decisions. Without one, those decisions will be made by your physicians according to state rules. These decisions could differ radically from the choices you would make for yourself.
In addition to carefully spelling out your wishes in a living will, you need to give careful thought to who will be your power of attorney or health care proxy. This individual will speak for you in the event that you become incapacitated, acting according to the instructions you have spelled out. This is a role of great responsibility, requiring someone whom you deeply trust.
The first inclination is to choose your spouse, and in some states your spouse will automatically be granted power of attorney if you become incapacitated. Remember, though, that your spouse is likely to be heavily swayed by emotion if these decisions need to be made. Choosing one of your siblings or a trusted friend may be a better option.
Before you draft a living will, sit down with the person you're considering for power of attorney. Explain the treatments that you do and do not want, and ask them if they're comfortable making these decisions for you. If they have strong religious or moral objections to your choices, find somebody else. Be aware, too, that choosing someone outside your immediate family can lead to tension between your power of attorney and your family.
You'll need to review your living will periodically, both to keep up with changes in medical technology and to make sure that your power of attorney is still the person you want in that role.
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