While living wills are most often discussed in the context of end-of-life care, they can also be used for permanently unconscious patients. If you fail to specify your wishes regarding life support under these circumstances, the hospital where you are being treated will apply their usual practices when making decisions about your care.
Living wills should be part of an overall estate planning strategy because there may come a time when you become unable to communicate your own desires for medical intervention. As such, others must know what kind of treatments you would consent to at different stages of a serious illness.
What Is a Living Will?
A living will or an advance directive is a legal document that expresses how someone would like to be treated in the case of their own incapacity.
This is different from a will. A will is a legal document that determines how someone’s property and possessions should be distributed after death. However, a living will gives instructions on what type of medical treatment an individual would like – or not like – to receive if they become incapacitated.
What Does It Include?
It can be short and simple, but legally valid documents typically include four key elements:
- The declarant must express themselves in clear, unambiguous language.
- The declarant must intend for the document to apply even after they are dead.
- The document must anticipate all possible scenarios because there is no way to predict exactly when or why an individual may become incapacitated.
- Anyone who has signed this document must understand what they are doing when they sign the document.
A living will can include your wishes for medical treatment and how you would like to be cared for, including pain control and maximum efforts to keep you alive. It may indicate whether you’d like to consider home health agencies for hospice care.
Why Create a Living Will
Although there is no legal requirement that every adult create a livingwill, it is strongly recommended that anyone with children or family members who depend on them consider drafting one. It helps clarify the wishes of an individual who may become unable to make their decisions due to illness or incapacity. It “brings order” out of confusion during this difficult time.
A healthcare power of attorney (also called healthcare proxy) can go hand in hand with a living will by designating someone else to make medical decisions on your behalf.
A living will can also benefit those who might otherwise want all possible life-saving measures taken, regardless of how low the chances may be that their condition could improve.
It can spare individuals from feeling pressured by significant others or healthcare workers into continuing treatment when they would prefer not to. This includes situations where one’s death is imminent and irreversible, like in cases of terminal illness or end-stage organ failure.
If no advance directive has been completed, state law automatically applies. This means you rely on government bodies (like the public guardian) to make medical decisions on your behalf. These typically consider factors like prognosis and medical wishes.
When Does One Need a Living Will?
A person needs to have a living will when they cannot communicate their wishes before they can no longer make decisions for themselves. It has become more common for people to create living wills during the last few decades because of advancements in medical technology.
For example, many now opt out of life-prolonging measures such as ventilators and feeding tubes, which were once seen as commonplace. Some people even choose not to receive CPR after cardiac arrest or decline blood transfusions due to religious beliefs or moral convictions. These types of situations are exactly what a living will is designed for.
What Does a Living Will Consist Of?
A living will consist of four parts:
1. An introduction that states the purpose, authority, and jurisdiction of the document
2. The patient’s statement, which contains each patient’s medical history in their words along with any specific wishes they may have in regard to end-of-life care
3. The healthcare proxy who makes all final decisions for the patient when they cannot speak for themselves. Generally, two different proxies are listed on this part of the form: one if both spouses agree or disagree on an issue together and another who can act independently if they don’t agree with their partner. Lastly, it is important to list everyone who can act as a proxy if the first two proxies disagree.
4. The witnesses sign this section of the document before a notary public or other official witnesses. This part serves to make sure that the patient was mentally competent and willingly created the advance directive.
Storage of a Living Will
A person should store their living will in multiple locations such as with their general healthcare information or medical records at work or school, someplace accessible by all your healthcare providers, and where it can be found easily if needed. It may also be appropriate to keep it with family members who have access to this information when necessary.
Unless you have designated someone as your healthcare proxy, no one can change your living will. However, if you are still mentally competent enough to make the changes for yourself, some states will allow you to do this by simple notarization or other formalities.
Creating a living will is not intended to take away the rights of anyone else but to ensure your final wishes are respected even after you are gone. This means that if someone wants life support measures taken, their loved ones will not be able to deny them simply because they have prepared an advance directive.
Living wills guide family members and medical professionals for everyone involved to say goodbye with as much grace as possible through the process of slipping away from this world.