Living Wills

Due to the very sad Terry Schiavo case, there has been a great deal of discussion about "Living Wills". A Living Will is not a usual will, which is a document where someone designates who will receive items from his/her estate. Instead, a Living Will – also known as a Declaration of a Desire for a Natural Death or other similar names – is a written statement of your desires about not being kept alive artificially if the situation is hopeless and you are not able to make your own decisions. (The problem in the Schiavo case was that she had not signed anything in writing regarding her preferences.)

Generally a Living Will states that it is the signer’s intent that no life sustaining procedures (meaning artificial life support, such as a ventilator for breathing) be used to prolong life if his/her condition is terminal or if he/she is in a state of permanent unconsciousness. Often a Living Will gives the signer the option of indicating that nutrition or hydration via inserted tubes be withheld in that situation as well. It is important to note, though, that the Living Will also states that medication or medical procedures are allowed to provide the signer with comfort care, such as pain medication, etc. The idea is to keep the signer as comfortable as possible while not using artificial means to needlessly prolong life. The Living Will can be tailored for whatever wishes the signer has.

A Living Will, though, is not sufficient by itself. It is far better to also sign a durable power of attorney for health care (called an Advance Health Care Directive in California). This document allows the person you designate – your "agent" – to make health-care decisions for you if you are incapacitated and cannot make your own decisions. (If you regain capacity, this person no longer has the power to decide for you.) A strong advantage is that it allows you to designate who you want to make these decisions for you; otherwise your first choice may not be the one making those decisions.

An Advance Health Care Directive allows your agent to have access to your medical records. (These days privacy regarding medical records is strict.) Often it also states your desire regarding life-sustaining medical treatment. Finally it allows you to express your desires regarding organ donations, autopsies and disposition of your remains.

An Advance Health Care Directive can "stand alone" because it can contain the same provisions as a Living Will. Still, many people prefer to have both documents, in order to reiterate their desire that they not be kept alive by artificial means.