The Living Will and Making Healthcare Decisions

According to the Prudential Life Insurance Company, a living will is a document which specifies the life-prolonging measures an individual wants and does not want taken on his/her behalf in the event of a terminal illness or disability. Living wills are often used in conjunction with a healthcare power of attorney, which appoints a person to make healthcare decisions.

No one likes to think about being in a situation where the fate of your mother, father, or another elder relative rests in your hands. However, if a situation arises where a loved one needs to have an emergency procedure performed, and you are the only one who can make that decision, what will you do? Do you know what their wishes are? The creation of a living will clarifies any decisions you need to make as well as any subsequent actions you take on their behalf.

As long as a patient is mentally competent, he or she can be consulted about preferred treatment options. When a patient has lost the capacity to communicate, however, the situation is different, and that’s when having a living will makes all the difference.

The Situation

According to The Living Will: A Guide to Health Care Decision Making by Hodgson, Russ, Andrews, Woods and Goodyear, Attorneys At Law, it is rare that anyone would know for certain exactly which treatments they don’t want in all cases. Most would agree that even short term unpleasant treatment is better than nothing. More than likely, there will be conditional wishes that will indicate the refusal of very specific treatments under certain but not all circumstances.

Basically, there are two types of situations where someone would have to make a health care declaration:

1. Terminal illness
2. Permanent disability
   

Terminal Illness – If the patient is unable to communicate, doctors may assume that the patient wants their life extended as long as possible. If the patient prefers a shorter, but more comfortable life during a terminal illness, that request can be made as well. Most standard health care declarations do address terminal illness, and most doctors readily respect the wishes expressed with respect to terminal care.

Permanent Disability – This situation is a bit more tenuous because doctors and other health care providers may attempt to, consciously or unconsciously, impose their own value system on a patient's case. While they may agree to withhold attempts to prolong life in terminal illness, they may vigorously oppose withholding treatment for chronic illness.

It is important to emphasize that there is a distinct difference between a living will and a last will and testament, specifically:

• A last will and testament deals with matters of property.
• A living will details individual health and personal care decisions.
• A last will and testament is only effective after a person dies.
• Living wills are used during life and may be modified if circumstances change.

Regardless of the situation, treatment preferences should be discussed with the person in need of a living will in advance. A doctor should also be involved so that the choices and instructions specified are suitable for that person’s particular health or medical issue. A living will can be drafted by an attorney or it can be written by the individual as long as proper steps are taken to ensure it is legal and valid. Also, as with a regular will, it is wise to keep this document updated and accessible for when it is needed.

Having the sole responsibility of making a sudden or life-saving decision is a burden that no one should have to bear. A living will effectively alleviates that pressure and ensures that the wishes of the patient are respected.