You’ve probably heard of “signing a DNR” — and that’s just one of the instructions you might leave in a living will. Designed to express your wishes for end-of-life medical care, this document can be as detailed as needed, and you can update it as your circumstances change.
What is a living will?
A living will is a legal document that specifies the kind of healthcare you want andwon’t don’t want to receive if you become incapacitated. Also called an “advance directive,” it guides doctors and family members about which course of treatment to take if you’re unable to express your wishes yourself.
How do living wills work?
A living will only comes into play when you’re suffering from a life-threatening illness, injury or coma and can’t communicate your wishes. In these cases, your healthcare team will consult the living will to determine whether or not you want life-sustaining treatment, such as life support or tube feeding.
If your life isn’t at risk, your living will won’t apply. Your doctors will proceed with treatment using their best judgment.
What does a living will include?
The document contains instructions for your medical care and goes through procedures you might undergo in a life-threatening situation. The most well-known advance directive is a “do not resuscitate” (DNR) order, but there are more.
You can indicate whether or not you approve of your doctors:
- Putting you on a machine to help you breathe, like mechanical respiration
- Employing CPR or a defibrillator to restart your heart
- Intubating
- Tube feeding
- Giving you life-saving medications or blood transfusions
- Administering dialysis
- Running diagnostic tests
- Performing surgery
- Starting palliative care, which might involve prescribing pain medications
- Recommending electroconvulsive treatments
You can also include instructions for:
- Donating your organs — and which ones you’d like to donate
- Receiving nutrition or fluids when you can no longer eat or drink
- An autopsy
- Donating your body to science or a medical school
- Your preference to die at home or in a hospital
Every condition in your living will is up to you. For example, you might not consent to any “extraordinary measures” if you suffer from a condition that severely impacts your quality of life. But you can request to be given pain medications so you’re comfortable.
You can also state that you want to stop treatment if there’s no sign of brain activity, or continue treatment up until the point where it’s clear that you won’t recover.
Is a living will the same thing as a healthcare proxy?
No. A healthcare proxy is someone you nominate to make medical decisions for you when you’re unable to do so yourself. In some states, this person is known as a “healthcare power of attorney.”
The proxy speaks to your doctors on your behalf, and has the final word on treatment — which can help to reduce confusion and settle any disagreement among family members.
You can list your healthcare proxy in your living will, but they are two separate things. Before you appoint a proxy, make sure they understand your wishes and are willing to follow through with them.
How to write a living will
Some states allow you to write a customized living will, while others offer a standardized form. You can hire a lawyer to prepare a living will for you, or simply download a living will form online.
Once you’ve written your living will, you’ll need to get it signed by a notary and two witnesses. There are some rules regarding witness eligibility. For example, some states ban the use of family members as witnesses, while others require you to have your document signed by adults over 18.
Can I update a living will?
Yes. It’s a living document, so you can make changes to it at any time — like when you have kids or learn of a new diagnosis. You can also update it while you’re in the hospital. You can also revoke your living will at any time.
What’s the difference between a will and a living will?
Both are legally binding documents that express your wishes, but they apply in different situations.
A will explains what you want to happen to your property, assets and minor children if you die. It clarifies how you want to allocate your assets, and prevents your state from stepping in. Without a will, the distribution of assets can be messy — especially if you have a large estate.
A living will addresses your end-of-life medical care, and if you consent to receive extraordinary measures to stay alive.
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Bottom line
A living will clearly states how you’d like to proceed with medical treatment if you can no longer communicate. If you don’t have one, your family could end up in a stressful situation, or your doctors might be legally obligated to perform procedures that are against your wishes.
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