Importance Of A Living Will
A living will is so called because it is a legal document in the United States that conveys a person’s wishes for medical care at times when they are unable to make their own decisions. These situations may include injury, terminal illness, dementia, coma, and other forms of incapacity or illness. A living will differ from a last will and testament in that it takes action only during your life instead of only after your death. A living will inform doctors of your preferences for medical treatments, ranging from full treatment to solely palliative care (pain reduction only).
A living will is a form of advance directive, a legal document with healthcare instructions. Another related advance directive called a power of attorney or health care proxy, allows you to appoint a trusted individual as a surrogate (also known as a proxy, agent, representative, attorney-in-fact, or advocate). Surrogates can sign forms and communication preferences on your behalf when you are incapacitated, so you may consider appointing one in addition to your living will. Because emergency responders must otherwise perform CPR and other emergency care by law, you may also consider establishing separate do not resuscitate (DNR) or do not intubate (DNI) orders in scenarios a living will do not cover. If you are nearing the end of life within one year, you may also consider the POLST (Physician Orders for Life-Sustaining Treatment): an additional document actionable across the entire medical community, including emergency responders. But advance directives, while especially valuable for senior citizens, can help patients through emergencies that arise at any age. It is important for all adults to establish a living will.
The rest of this article will explain how a living will cover a wide array of treatment preferences and is easy enough to establish and maintain. By the end of it, you will hopefully have a better idea about how, when, and why you should establish your own living will and encourage loved ones to do the same.
Why You Should Establish a Living Will?
A living will determine your stated preferences as to whether or not you wish to receive the following forms of care:
- Cardiopulmonary resuscitation (CPR), or the use of pressured resuscitation or electric shocks to restart a stopped heart
- Tube feeding, or the transfer of fluids and nutrients into the stomach or veins through a tube or intravenous therapy (IV) –generally IV in the short term and tube feeding in the long term
- Dialysis, or artificial cleaning of blood by machine in the event of kidney problems
- Mechanical ventilation, or artificial breathing by machine in the event of breathing problems
- Antibiotics and antiviral medications, or those medications that fight microbial infections (at the risk of their developing antibiotic resistance)
- Palliative care, or pain reduction and comfort measures such as pain medications and hospice care at home (sometimes in the absence of other, potentially painful treatments)
- Organ and tissue donations, or donating organs to other patients in need during a temporary period of life-sustaining treatment (not to be confused with a request for permanent life-sustaining treatment, as the form should make clear to healthcare providers)
You should establish a living will because it will clarify your wishes regarding this wide and varied list of treatment options. Many disputes have arisen about the wishes of patients without living wills, such as the highly-publicized case of Terri Schiavo –whose husband and parents had 10 years of court battles about whether or not to keep her on life support due to conflicting opinions on what her wishes were. A living will dispel all doubt about a patient’s wishes, as can an official surrogate properly informed of them.
There are many factors to consider in writing a living will, such as whether or not you would want to stay on life support in all scenarios, whether you would endure pain or other negative side-effects for the sake of a cure or die peacefully, and whether or not the treatment’s outcome justifies the financial, physical, or emotional cost to yourself or your loved ones. Many of these decisions will depend on personal values, both moral and practical, that vary from person to person. The next section of this article will explain how to set these values in stone after deciding on them.
How to Write a Living Will?
As previously mentioned, the first step of writing a living will is determining your wishes based on your values and prior conversations with family and doctors. The treatment options above fall into three basic categories: Life Support, Life-Sustaining Treatment, and End-of-Life Wishes –the last of which may also include specific wishes for your funeral services. After filling in the form, signing it may require a witness signature or notarization depending on where you live. Forms and their legal requirements vary from state to state, and you can obtain free, state-specific forms from the AARP or the American Bar Association. You do not require a lawyer to fill out the form, but their assistance can be helpful. The same goes for designating a surrogate through an additional power of attorney advance directive.
Once you have filled in the living will form, review it with your doctor and surrogate to make sure you have listed everything correctly. Keep your original copies in a safe and accessible place wherever you go, make sure your doctor and surrogate have copies and make note of which people have the copies; these steps will ensure that a copy is always available within healthcare providers’ reach. Discussing the living will with family and carrying a card that identifies the form’s location can also dispel confusion. Changing your living will require you to make new forms to replace the old ones; new diagnoses, changes in your wishes over time, and revised choices of surrogates may convince you to redo your living will.
Treat a living will like a living thing: able to change and take action at any time a need arises, and therefore worthy of careful consideration. However your will to live may be affected by emergency scenarios, a living will ensure that you live the rest of your life to its fullest no matter what.
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