Living Will

Crafting a Living Will: Balancing Medical Ethics and Personal Values

What is a Living Will and how does it differ from a Last Will and Testament?

A Living Will is a legal document that specifies a person's wishes for end-of-life medical care. It differs from a Last Will and Testament in several key ways:

Purpose: A Living Will focuses on medical decisions, while a Last Will deals with asset distribution after death.

Timing: A Living Will takes effect while you're still alive but incapacitated; a Last Will only after death.

Scope: Living Wills cover healthcare decisions; Last Wills cover property and guardianship matters.

Flexibility: Living Wills often allow for more immediate changes as health conditions evolve.

Medical Focus: Living Wills specifically address treatments like life support, feeding tubes, etc.

Legal Requirements: The witnessing and execution requirements often differ between the two.

Revocation: Living Wills can often be more easily revoked or changed, sometimes verbally.

Duration: A Living Will typically expires upon death, while a Last Will takes effect at that point.

What key decisions are typically covered in a Living Will?

A Living Will typically covers several critical medical decisions:

Life-Sustaining Treatments: Preferences for or against treatments like ventilators or dialysis.

Artificial Nutrition and Hydration: Wishes regarding feeding tubes and IV hydration.

Pain Management: Directions for pain relief and comfort care measures.

Organ Donation: Preferences for organ and tissue donation.

Do Not Resuscitate (DNR) Orders: Instructions regarding CPR or other resuscitation efforts.

Experimental Treatments: Willingness to participate in experimental or novel treatments.

Blood Transfusions: Acceptance or refusal of blood transfusions, often based on religious beliefs.

Mental Health Treatments: Preferences for psychiatric or psychological interventions.

Pregnancy Provisions: Special instructions if the person is pregnant at the time decisions are needed.

Palliative Care: Preferences for end-of-life comfort and hospice care.

Who should have a Living Will?

While often associated with older adults, a Living Will is valuable for many individuals:

Adults of All Ages: Unexpected medical emergencies can occur at any time.

Individuals with Chronic Illnesses: To specify preferences as their condition progresses.

People with Strong Healthcare Preferences: To ensure their specific wishes are known and followed.

Individuals with Religious or Cultural Beliefs: To outline care aligned with their values.

People Without Close Family: To provide clear directions in absence of immediate family.

Those in High-Risk Professions: Due to increased likelihood of serious injury.

Frequent Travelers: To ensure wishes are known if incapacitated away from home.

People with Family History of Hereditary Diseases: To prepare for potential genetic conditions.

Parents: To ensure their care preferences don't burden their children with difficult decisions.

Anyone Valuing Autonomy: To maintain control over their healthcare decisions even when incapacitated.

How is a Living Will legally enforced?

The legal enforcement of a Living Will involves several aspects:

Legal Recognition: Most jurisdictions legally recognize Living Wills as valid advance directives.

Healthcare Provider Compliance: Medical professionals are generally required to follow the instructions in a valid Living Will.

Proxy Decision Maker: Often accompanied by a healthcare power of attorney designating someone to make decisions.

Hospital Protocols: Many hospitals have procedures to check for and comply with Living Wills.

Legal Penalties: In some areas, there may be legal consequences for willfully ignoring a Living Will.

Court Intervention: In disputes, courts can intervene to enforce the terms of a Living Will.

Portability: Many regions have laws ensuring Living Wills are honored across state lines.

Overriding Circumstances: Certain situations (like pregnancy) may legally override some Living Will provisions.

Revocation Rights: The creator retains the right to change or revoke the Living Will while competent.

Ethical Considerations: Medical ethics committees often consult Living Wills in complex cases.

Can a Living Will be changed or revoked?

Yes, a Living Will can be changed or revoked, but there are important considerations:

Mental Capacity: Changes must be made while the person is of sound mind.

Written Changes: Formal amendments should be in writing and properly witnessed.

Complete Revocation: One can completely revoke a Living Will and create a new one.

Verbal Revocation: In emergencies, many jurisdictions allow verbal revocation to healthcare providers.

Notifying Relevant Parties: It's crucial to inform family, doctors, and proxy decision-makers of changes.

Destroying Old Copies: Physically destroying outdated versions helps prevent confusion.

Regular Review: Periodic review ensures the document remains aligned with current wishes.

Life Changes: Major life events often prompt reconsideration of Living Will provisions.

Medical Advances: New treatments or diagnoses might necessitate updates.

Legal Changes: Changes in laws might require adjustments to ensure continued validity.