What a Living Will States

A Living Will is a document in which you give directions regarding life sustaining or death delaying treatment should you become unable to communicate your wishes. In short, it is the “pull the plug” document. A Living Will is sometimes encompassed within an Advance Health Directive, an Advance Health Care Directive, or a Durable Power of Attorney for Health Care.

As long as you are mentally competent, you can be consulted about desired treatment. When you have lost the capacity to communicate, however, the situation is different and a Living Will can direct someone you have appointed to follow your instructions. This document states specific directives as to the course of treatment that is to be taken by caregivers if you become incapacitated. This can also include treatments that you forbid. You should realize that if you do not express your views, treatment to maintain your life, by whatever means available, would probably be provided once you are no longer able to communicate, even if family members object. Therefore, if there are conditions under which you would not want treatment, it is important that you communicate your wishes while you are able to do so.

What Does a Health Care Agent Do?

An “Agent” is whom you appointed to make health care decisions for you should you be unable to do so. The person chosen is known as the “agent” and you are known as the “principal.” If you become unable to make your own health care decisions, your agent will have legal authority to speak for you in health care matters. Physicians and other health care professionals will look to your agent for decisions rather than your next of kin or any other person. Your agent will be able to accept or refuse medical treatment; have access to your medical records; and make decisions about donating your organs, authorizing an autopsy, and disposing of your body should you die. If you do not want your agent to have certain of these powers or to make certain decisions, you can write a statement in your Health Care Power of Attorney limiting your agent’s authority.

When you become incapacitated, your agent must make decisions that are consistent with any instructions you have written in your Living Will or made known in other ways, such as by telling family members, friends or your doctor. If you have not made your wishes known, your agent must decide what is in your best interests, considering your personal values to the extent they are known.

You can appoint almost any adult to be your agent. You can choose a member of your family such as your spouse or an adult child, a friend, or someone else you trust. You can also appoint one or more “alternate agents” in case the person you select as your health care agent is unavailable or unwilling to make a decision. It is important that you talk to the people you plan to appoint to make sure they understand your wishes and agree to accept this responsibility.

Beyond Writing a Living Will

One of the most important parts of completing a Living Will is having a conversation about it with your loved ones and your physicians. You should talk about your personal values and what makes living meaningful for you; your current medical condition, and decisions you may foresee in the future. Tell them what concerns you most about death and how you would want to spend the last month of your life. Specifically, you should talk about concerns or wishes you have regarding life support, aggressive intervention, hospice, and long-term care.

Be sure to tell your loved ones that you have completed a Living Will and exactly what you have said in it. If you have also completed a Health Care Power of Attorney, let them know whom you have chosen as your health care agent. They will need to know where copies of your Living Will and Health Care Power of Attorney can be found.

It is important that you discuss your health care desires with your physician. He or she is likely to be the one caring for you when your instructions become relevant and is much more likely to honor requests that have been communicated directly. Furthermore, your physician can help you phrase your requests in a way that makes sense to physicians and can answer any questions you may have. Finally, your physician can point out any illogical or inconsistent features of your requests. Sometimes refusing one kind of treatment makes it illogical to expect to receive another kind of treatment. Your physician can smooth out some of these “rough edges” and help make your Health Care Power of Attorney and Living Will consistent and coherent.

Despite your best efforts to plan for all eventualities in a Health Care Power of Attorney and Living Will, actual events may not “fit” your directives. That is why it is so important that you discuss your feelings with family and friends. They can then often help clarify your directives on the basis of recollections of specific discussions under specific circumstances. In addition, if you have discussed your wishes with a number of people, it is more likely that those wishes will be honored.

Treatment decisions are difficult. That is why it is important to think about your wishes in advance, discuss these wishes with your family, friends, and health care professionals, and make plans for your future health care needs. Since it is important that your wishes be documented in the most effective way possible, it is recommended that you consult a qualified estate planning attorney in regard to the preparation of a Health Care Power of Attorney and Living Will.