Living Will Precautions

by Lee Carroll
Your doctor can help you decide which instructions to include in a living will.

Your doctor can help you decide which instructions to include in a living will.

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A living will is a document that explains your final health care wishes to medical professionals and family members. It is activated if you are unable to communicate those wishes on your own due to an illness, accident or advanced age. Living wills usually focus on whether the patient wants resuscitation, artificial life support and other life-prolonging medical care.

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Validity

Your living will must be created and witnessed according to the laws of your state, or a judge could rule that it is invalid. Although laws vary, they are similar to making a last will and testament. You must be a legal adult who understands the purpose of a living will, and you must have a sound mind and act freely without coercion. Witness requirements also vary, but a witnessed and notarized living will that is filed with your doctor is a better option than writing down your wishes and storing them secretly. A living will is invalid if you created it before you were a legal adult, even if you are of legal age when the document is needed. Living wills that direct health care professionals to medically induce death -- sometimes called assisted suicide -- are usually invalid.

Revisions

A living will drafted at one stage of your life may become outdated as the years go by. Medical solutions that are impossible now may be commonplace when you are older, or you may simply change your mind about whether you want life-sustaining measures. As long as you are competent and coherent, you can revise your living will or replace it with a new one at any time. Destroying an outdated living will can help avoid confusion and disagreements among family members.

Clarity

Some people do not want medical intervention to keep the heart beating and lungs breathing if there is no chance for brain activity or a normal life. Those same people might want emergency intervention such as CPR and temporary life support if there is a good chance that they will recover. If your living will is not clear, your wishes could be misinterpreted by well-meaning doctors and nurses. It is better to err on the side of caution and provide instructions in explicit detail than to assume your wishes will be fulfilled.

Emergencies

Emergency workers outside a hospital may provide CPR or perform other emergency intervention even if your living will states DNR, or Do Not Resuscitate. DNR means that if your heart or breathing stops, you do not want medical professionals to intervene. It is difficult to avoid the possibility of intervention outside a hospital, as emergencies by nature require immediate action. Your living will may not be known to the workers. Notifying family members of your wishes and giving them access to your living will can help prevent or encourage intervention in an emergency.

Palliative Care

Avoiding artificial life support does not mean that you must suffer until death. Palliative care is focused on easing the suffering that accompanies serious or terminal illnesses and injuries. Adding palliative care wishes to a living will can insure that you receive pain medication or sedation until death occurs even no life-sustaining measures are taken. Administering or denying food and water is one consideration. If your living will prohibits tube hydration or feeding, death may occur more quickly. With pain medication or sedation, the discomfort associated with starvation and dehydration may not be a concern. Including palliative care wishes in your living will relieves your family of the burden of making those difficult decisions for you.

Power of Attorney for Health Care

You may select a person to act on your behalf in the event that your living will is activated. A medical or health care power of attorney is a separate document that names your representative, and usually an alternate, who communicate with health professionals on your behalf when you are unable to. Having both a living will and a durable power of attorney increases the likelihood that your wishes will be followed. A divorce may nullify a durable power or attorney that only names your spouse as representative, so naming an alternate is wise.