A living will is a brief declaration or statement that a person
may make indicating their desire that certain medical treatment be either
withheld or withdrawn under certain circumstances. Most states have statutes
authorizing the creation of living wills, that specify that the statement
or declaration be in substantially the following form:
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"I have the primary right to make my own decisions
concerning treatment that might unduly prolong the dying process. By this
declaration I express to my physician, family and friends my intent. If
I should have a terminal condition it is my desire that my dying not be
prolonged by administration of death-prolonging procedures. If my condition
is terminal and I am unable to participate in decisions regarding my medical
treatment, I direct my attending physician to withhold or withdraw medical
procedures that merely prolong the dying process and are not necessary
to my comfort or to alleviate pain. It is not my intent to authorize affirmative
or deliberate acts or omissions to shorten my life, rather only to permit
the natural process of dying."
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How
is a Living Will Made? |
Any competent person 18 years of age or older can make a living will
by signing and dating a statement similar to that shown above before two
witnesses. These witnesses must be at least 18 years old, and should not
be related to the person signing the declaration, a beneficiary of his
or her estate or financially responsible for his or her medical care. The
statement can be typed or handwritten. It is recommended that a living
will or any other advance directives be considered and prepared in advance
of any hospitalization or impending surgery it is not something anyone
should feel pressured to decide in a short period of time, if that can
be avoided.
Limitations
of Living Wills |
While most people have heard of living wills, many are unaware of
the significant limitations of the living will as defined by state statute.
The terms "death-prolonging procedure" and "terminal condition" are used
in most statutes to specify the circumstances to which a living will applies.
The statutes define both of those terms as relating to a condition where
death will occur within a short period of time whether or not certain treatment
is provided. In other words, the patient will die shortly with or
without artificial resuscitation, use of a ventilator, artificially supplied
nutrition and hydration or other invasive surgical procedures. By definition,
then, a living will only avoids treatment when death is imminent and the
treatment is ineffective to avoid or significantly delay death. Furthermore,
the statute prohibits a living will from withholding or withdrawing artificially
supplied nutrition and hydration, which is sustenance supplied through
a feeding tube or IV.
Alternatives
to Living Wills |
For patients who desire to give instructions for their health care
which exceed the limitations of the living will statute, there is an alternative,
commonly referred to as "advance directives." An advance directive is an
instruction by a patient as to the withholding or withdrawing of certain
medical treatment in advance of the patient suffering a condition which
renders the patient unable to refuse such treatment. A competent patient
always has the right to refuse treatment for himself or herself or direct
that such treatment be discontinued. Without an advance directive, once
a patient becomes incapacitated, he or she may well lose that right. A
living will is simply one type of advance directive. Recent court cases
have made it clear that people have the right to make other types of advance
directives which exceed the limitations of the living will statutes. Those
directives need to be "clear and convincing," and may include instructions
to withhold or withdraw artificially supplied nutrition and hydration or
other treatment or machinery which may maintain a patient in a persistent
vegetative state. These expanded advance directives can be tailored to
meet the needs and desires of each individual patient, and need not be
in any standard form. For example, they can specify that certain procedures
are to be used for a reasonable period of time and then discontinued if
they do not prove to be effective. Generally, additional advance directives
should be signed, dated and witnessed in the same manner as living wills.
What
Should I do With My Living Will? |
The most important part of having a living will or other advance
directives after they are signed is to be certain that they are accessible.
They should be kept close at hand, not in a safe deposit box, because they
may be needed at a moment's notice. Many people travel with them. Some
even keep them in their purse or billfold. At a minimum, it is recommended
that you deliver a copy to your attending physician and at least make your
close relatives aware that you have one. Giving a copy of your living will
or other advance directives to your physician gives you an opportunity
to discuss your desires and ask any questions you may have about any procedure
and also to ask your physician if he or she will follow your directions.
If you have appointed an attorney-in-fact to make health care decisions
in case of your incapacity, he or she should have a copy. If you are hospitalized,
a copy should go into your medical records. For these reasons, it is often
wise to sign more than one copy of your living will or other advance directives.
Once made, a living will or other advance directives are easily revoked
or cancelled. They can be revoked either orally or in writing. If
possible, it is advisable to gather and destroy all copies of the advance
directives if you desire to revoke them. By most statutes, health
care providers are required to note a revocation of a living will in the
medical records of the patient.
Why
Give Advance Directives? |
You accomplish at least two things by giving advance directives,
regardless of whether they direct all possible treatment, no treatment
or only some treatment. First, you ensure that the treatment you receive
is the treatment you desire, no more and no less. Second, you take the
burden off of your family and friends to make those decisions for you at
a time when they will most likely be emotionally upset by your critical
condition. Finally, you may be avoiding litigation to determine what treatment
you really desired or intended. In any event, it is time well spent.
Living
Wills - Questions and Answers |
A written legal document Signed by the person making the Living Will
Also signed by two witnesses unrelated to this person The document must
comply with the laws of the state.
Who can make a Living Will? |
Any person who is competent under the laws of that state to make
a contract can make a Living Will.
What does a Living Will do? |
The Living Will formalizes a person's wishes regarding the type of
medical treatment and care to be used or withheld in the event of a serious
illness.
How long is a Living will valid? |
Until revoked by the person who signed the document.
Can a Living Will be changed? |
YES! The Living Will can be revoked as long as the person
remains competant, and a new document prepared.
Why should I have a Living Will? |
A Living Will documents the amount and types of medical treatment
and care you wish to receive during a serious illness or incapacity.
The educational information provided
here is only general in nature and is not intended as a legal opinion.
For specific advice or assistance, please contact a legal professional.