A living will is the legal document document where you list your wishes for whether or not you want to pull the plug. It is one aspect of a proper estate plan, but it is very significant because it conveys your final wishes to your loved ones and medical providers.
Having a living will encourages you and your family to discuss what’s important to you at each stage of your life, and what sacrifices you are willing to make to live longer.
Of course we want to live our lives as long as possible, and if we can get better, we want our family to ensure we get the proper treatment. That being said, a living will is grounded in the reality that often, we spend our last days on earth helpless, dependent on others, confused, or in pain. Many of us would rather be at home than in a hospital and we certainly do not want our loved ones to spend extraordinary amounts of money in heroic efforts that merely delay the inevitable.
What goes into a living will?
You will provide your personal information, provide your end of life health care decisions, and sign it in front of a notary public or witness.
You will reference the agent named in your health care power of attorney document as the person who can continue making medical decisions on your behalf and in conjunction with your wishes laid out in the living will. Your agent will have the ability to decide whether or not to sign a Do Not Resuscitate Order, and can refuse heroic measures on your behalf.
However, and as long as you are not incapacitated, you are the only person who can follow or disregard the living will.
When you prepare your living will, you are given the option to choose to extend your life or to refuse or remove artificial life sustaining treatment in a variety of medical situations, including:
- Mild, moderate, and severe dementia;
- Vegetative state;
- Irreversible coma;
- Beginning and advanced stages of neurological disorders such as Parkinson’s or ALS;
- End-stage renal disease;
- Severe chronic pulmonary disease (C.O.P.D);
- Severe congestive heart failure; and
- End-stage organ failure.
You can also select to be kept alive for as long as possible or to refuse artificial life saving treatment if:
- You are in the advanced stages of any incurable disease and the quality of your life is severely diminished due to the toll that medical treatment, numerous doctor appointments, and the illness is taking on you;
- Treatment options would be very painful in the long run;
- You are in a permanent situation where you are unable to engage in the world around you, except sporadically and minimally; or
- The only option for treatment of your medical needs is permanent placement in a nursing home
Importantly, even if you deny artificial life sustaining treatment, a living will acknowledges that you want to be in comfort and free from pain. This document authorizes treatment with pain medication, both for physical pain and for any mental anxiety. It also authorizes comfort care to keep you clean, and states your preferences as to where you would like to die.
What is artificial life sustaining treatment?
Artificial life sustaining treatment is a very broad term. It can include:
- Breathing machines and other assistance in breathing
- Artificial feeding methods
- Any type of surgery
- Blood transfusions or infusions
- X-rays, blood work, or other diagnostic tests
- Medications used to fight infections, including antibiotics
- Having a pacemaker inserted or having the battery replaced
- Cancer treatment, including chemotherapy
- Any experimental treatments, or
- Medication that increases blood pressure
Living Wills, like all estate planning documents, can be customized to reflect your personal beliefs. For example, if you are in a coma or vegetative state, you may wish to be kept alive to the greatest extent possible for a certain number of days or until your children who live out of state are able to come see you.
Speak with your attorney to discuss other directives you wish to include in your living will.
When can I sign a living will?
You can prepare a living will at any time – the sooner, the better. You need to make your wishes clear when you are of sound mind.
What does not go into a living will?
A living will is extremely limited in scope. This is not the document you fill out when you want to authorize organ donation, nor does it allow you to provide specific instructions regarding disposal of your remains. In order to make those decisions clear to your family members, you should create a durable health care / medical power of attorney. In addition to giving your family members authority to donate your organs and tissues, your agent will have authority to make medical decisions on your behalf.
This article does not provide legal advice. To discuss your estate planning documents, including living wills and powers of attorney, contact Susan Sandys, an experienced attorney, for a free consultation. Prepare your living will while you are of sound mind before it’s too late.