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Living Wills: What They Do and How They Work

4 min read

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By Thomas Rosen

A living will voices your wishes for your medical care if you become incapacitated. Find out why this document is so important for you and your family.

You probably already know that a last will and testament ensures that your wishes regarding your estate and other matters are carried out after you die. But who will make decisions for you if you become incapacitated and can no longer make them on your own while you’re still alive? A living will can be invaluable in laying out what you want to happen if you should be unable to communicate your wishes due to a serious medical problem while you’re still alive.

Estate planning and end-of-life issues go hand in hand, which is why it’s important to consider having a living will as part of your overall estate plan. Most people don’t want to contemplate the end of life and all the legal ramifications that are involved with death and dying, so many people don’t recognize the importance of having a living will in place. One study suggests that roughly only 29% of adults have a living will in place, an indicator that many Americans are inclined to avoid end-of-life planning altogether.

So, what is a living will, how do they work and do you need one?

Basic Living Wills

A living will is a legal document that lets your personal choices about your end-of-life treatment be known. It directs all medical care that you want to receive, including any procedures you’re comfortable with having and medications that you will take (or, inversely, don’t want to be included in your medical treatment plan). It may, in some cases, state your preference for being nourished artificially or being put on a ventilator and, if so, for what period of time and under what circumstances. In essence, the living will is your voice to your doctors when you can’t literally speak to them. Living wills typically come into play when the creator of the will is in a terminal state or is unconscious, often due to an accident or when going under anesthesia for a planned surgery.

Is a Living Will the Same As An Advance Directive?

Depending on which state you live in, a living will may be called an “advance directive” or the terms may be interchangeably used. In most states, however, an advance directive is made up of several different documents, of which the living will is just one piece of the puzzle. In addition to a living will, an advance directive may also include documents such as a medical power of attorney, a DNR (Do Not Resuscitate) order, organ donation waivers and other documents. Confusingly, some states may also call a living will a “declaration regarding life-prolonging procedures” or a “directive to physicians.” No matter what it’s called, the living will speak for you regarding important decisions if you become unable to speak for yourself.

Keep in mind that a medical power of attorney or POA is not the same thing as a living will. The medical POA appoints a medical representative, aka healthcare proxy, to act on your behalf if you can’t speak for yourself in regard to medical decisions. The person named in the POA makes decisions based on what you have discussed with them.

Warning: It is possible to have both a medical POA and a living will, but it can cause conflicts when the designated POA doesn’t fully agree with the directives of the living will.


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Points to Address in a Living Will

Some of the toughest times come at the end of life, but with a living will in place, you don’t have to burden loved ones with making painfully difficult medical choices. The points you address in your living will make it clear what you want, so they don’t have to second guess what you would expect of them at this emotionally charged time.

Some points to consider when drafting your living will include what would happen if you can’t breathe without mechanical respiration or if you can’t feed yourself and need to be outfitted with a feeding tube. You should also lay out in certain terms if you want to be resuscitated or intubated and for how long you’d be comfortable being in a state that requires intubation and artificial breathing mechanisms. It is a good idea to note any palliative care choices you want to make in advance, such as hospice treatment at home or in a facility. Lastly, you should let it be known if you want to make anatomical gifts and donate your organs or even your body once you’re deceased.

Keep in mind that a living will only goes into effect if you are unable to communicate but still living. For example, you are placed in a coma due to injury and your doctors need to look at treatment plans based on your wishes. If you become able to communicate again, the living will’s authority stops.

Do You Need a Living Will?

A living will makes things easier for family if you become seriously ill or injured. However, a medical POA may be sufficient, provided you trust the judgement of your selected POA. In general, all adults should probably have a living will or designated medical POA if for no other reason than to ease the decision making on loved ones in a worst-case scenario.

Each state has specific rules about living wills, so it’s always a good idea to speak with an attorney or estate planner when you decide to make a living will. Many attorneys recommend a living will be drawn up when you create your last will and testament.

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Thomas Rosen



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