What Circumstances Can Overrule a Living Will?

by Dennis Masino
Living wills help a family comply with your medical care wishes.

Living wills help a family comply with your medical care wishes.

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Many people are concerned about the type of medical care and treatment they will receive if they are terminally ill. Some people want cardiac resuscitation, mechanical respiration, and feeding tubes for hydration and nutrition to prolong life while others don't. Living wills give you the opportunity to make your wishes known in the event you are later unable to communicate these wishes to doctors and family. Living will directions are not without limitations. States are free to pass laws limiting the effect of a patient's instructions contained in a living will.

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State Laws

States are free to limit the circumstances under which a person may control the medical care they will receive if they cannot communicate those wishes to the doctors. Missouri, for example, authorizes a patient to set limits on treatment only when death is imminent and the treatment will not avoid or significantly delay it. It also prohibits living will provisions with regard to the withholding or withdrawal of artificial nutrition or hydration. Other states, such as New York, have no such limitations on the directions a person may include in a living will.


A living will reflects your wishes with regard to the medical treatment you want administered or withheld in the event of a terminal illness. Many states have enacted laws, however, that make living wills invalid if the patient is pregnant. States with such laws recognize the rights of the unborn child.

Emergency Medical Services

Living wills are often associated with medical treatment provided in a hospital or other health care facility. If a person is incapacitated and suffering from a terminal illness, doctors can look to a properly prepared and signed living will for guidance as to the person's wishes. In some states, such as New York, emergency medical services personnel are prohibited from relying on a patient's living will when providing medical care outside of the hospital setting.

Doctor's Conscience

A doctor may decline to honor the wishes of a patient as expressed in a living will if the doctor's conscience would be violated by doing so. A doctor may also decline to honor the living will if the patient's instructions violate the policies of the hospital in which medical care is being given. In either situation, the doctor must arrange for the transfer of responsibility for the patient's care to another doctor or new facility so the wishes of the patient can be honored.