Understanding Living Wills
A living will contains written instructions in which people can describe which life-sustaining treatments they want and which they don’t want—if a time should come when they are no longer able to make decisions. Early living wills were simply letters people wrote listing their wishes. Now, most states have a specific form—or at least specific language—that they like people to use for a living will.
Keep in mind that living wills deal with medical matters as opposed to “regular” wills which concern business and financial issues. All 50 states have some form of living will.
Generally, a living will expresses someone’s wish not to be kept alive by artificial means—such as with a ventilator—if he or she is terminally ill or in a persistent vegetative state. However, it is helpful to have additional written information attached to the living will that specifies what treatments are desired—and which are not.
With a living will, a person can communicate his/her wishes for end-of-life care to family members and to doctors. These wishes might include preferences about:
- CPR
- Tubes to provide nutrition and/or hydration
- Kidney dialysis
- Ventilators
- Blood transfusions
- Invasive procedures
- Pain medication
- Surgery
- Organ transplantation
- Chemotherapy
- Antibiotics
- Dying at home or at a medical facility
All people have their own beliefs about the end of life. Some cultures may not support the idea of a living will. However, leading representatives of many major religions have spoken out in favor of a person’s right to die a natural and dignified death.
A living will becomes effective when it is determined that a person can no longer make his or her own decisions. As long as the requests in the living will are legal (and don’t go against reasonable medical standards), doctors will usually honor them.
However, this issue is never completely clear. For example, if a doctor has to choose between a living will that the patient never talked to him about and a recent discussion he had with the patient about end-of-life care, he will usually go with the recent discussion—even if it goes against the instructions in the patient’s living will.
Living wills must be signed and dated. They must also be signed by two witnesses. Healthcare workers should never be witnesses to a living will! If a client asks you to be a witness, explain that it’s against your workplace policy.
A person must be at least 18 years old to sign a living will. Children younger than 18 have their medical decisions made by their parents or legal guardians.