· What is a living will?
A living will, or advanced medical directive, is a legal document which directs your physician to discontinue life-sustaining procedures if you are in a terminal condition or a permanently unconscious state.
It is considered a final expression of your right to refuse medical treatment which should be followed by your physician. Many people execute living wills so that family members or other loved ones are not put in the position of having to decide whether to terminate or continue life-sustaining treatment when there is no hope of recovery.
The living will is now recognized in virtually all states. Most states have very detailed laws setting forth the language that must be included in order for the document to be valid. As each state has different laws, it is a good idea to check with an attorney in your state to get more information on your state’s requirements.
· Who decides whether or not to invoke the terms of my living will?
You should be aware that most major hospitals have created “ethics” panels or independent review boards which consist of physicians, nurses, and other personnel not currently involved in the treatment of the individual in question. These panels or boards review the situation and give the treating physician(s) direction.
You should ask your local hospital (or the hospital where you may be taken if you have a severe or terminal condition) what its policies are in regard to living wills.
· How are living wills misinterpreted?
Living wills are sometimes misunderstood as the equivalent of a “do not resuscitate” (DNR) order, which is an agreement between the patient and the physician that the patient will not be resuscitated if sudden unconsciousness occurs. This situation could occur even if there is no terminal illness meeting the narrow conditions described above for invoking the living will.
For example, a woman who had just had a hip transplant was being wheeled to the recovery room when she suffered a cardiac arrest and lapsed into unconsciousness. The hospital personnel made no attempt to resuscitate her “because she has a living will.” This was an improper use of that document because a hip transplant is not a terminal illness from which there is no reasonable prospect of recovery.
· What is a power of attorney for health care?
Beyond expressing your wishes as to life-sustaining issues, you may also express your wishes with regard to courses of medical treatment. In a power of attorney for health care, you name a surrogate or attorney-in-fact to make medical decisions for you if you are unable to do so yourself. For instance, if major surgery or long-term treatment is proposed and you are too ill to make your feelings known, your surrogate would invoke the power of attorney to facilitate your wishes.
· What are some of the issues that I may wish to address in my living will and other medical directives?
Some of the issues you may want to address specifically are terminal conditions or illnesses (such as certain types of cancer, stroke, and major heart problems), vegetative states, and the types of treatments you may want to have withheld (such as tube feeding, artificial nutrition, hydration—in all their various forms). Your personal medical concerns may dictate other issues that should be included. Be sure to address quality-of-life issues and make an express statement of your desire and philosophy regarding your right to die with dignity.
It is impossible to create the perfect document when you cannot know what the specific situation will be at the time help is needed. With comprehensive medical directives, however, you should have some peace of mind that your wishes have been made known and that your desires will be carried out.