Advance Medical Directive (or Living Will): A living will is a written declaration in which you state in advance your wishes
about the use of life prolonging medical care if you become terminally ill and unable to communicate. It lets your wishes be
carried out even if you become unable to state them. If you don’t want to burden your family with the medical expenses and
prolonged grief involved in keeping you alive when there’s no reasonable hope of revival, a living will typically authorizes
withholding or turning off life sustaining treatment if your condition is irreversible. Living wills typically come into play when
you are incapable of making and communicating medical decisions. Usually, you’ll be in a state such that if you don’t receive
life sustaining treatment (intravenous feeding, respirator), you’ll die. If your living will is properly prepared and clearly states
your wishes, the hospital or doctor should abide by it, and will in turn be immune from criminal or civil liability for withholding
treatment. Some people worry that by making out a living will, they are authorizing abandonment by the medical system, but a
living will can state whatever your wishes are regarding treatment, so even if you prefer to receive all possible treatment,
whatever your condition, it’s a good idea to state those wishes in a living will. Health-Care Powers of Attorney:
A special kind of durable power of attorney called a health-care power of attorney (HCPA) deals with health-care planning. In
it you appoint someone else to make health-care decisions for you including, if you wish, the decision to refuse intravenous
feeding or turn off the respirator if you’re brain-dead–if you become incapable of making that decision. The form can be
used to make decisions about things like nursing homes, surgeries, and artificial feeding. Since it’s simply impossible to
predict every possible contingency in an advance medical directive, having both a living will and a HCPA enables you to
handle other kinds of disability, or gray-area cases where it’s not certain that your terminally ill, or your doctor or state law fail
to give your wishes due weight. Better to have a trusted relative or friend make the call.
ADVANCE MEDICAL DIRECTIVES
Finally, despite recent changes in the law, old habits die hard, and many doctors and nurses are still reluctant to turn off life
support—even if that’s what the patient wants. That’s why you need an advocate appointed by your HCPA to press your
intentions. Obviously, such important decisions should be discussed in advance with your agent, who should be a spouse,
child or close friend. You should try to talk about various contingencies that might arise and what he or she should do in each
case. Make sure you put a copy the HCPA in your medical record. Since it’s so much more flexible than a living will, the HCPA
is a very useful document that could save you and your family much anxiety, grief, and money. You can revise or revoke the
HCPA (or the living will) at any time, including during a terminal illness, as long as you are competent and are following the
procedures set out in your state’s law. When you change or revoke either document, notify the people you gave the copies
to, preferably in writing.
Comprehensive Directives: It’s a good idea to prepare the HCPA and living will at the same time, and make sure they’re
compatible with each other and the rest of your estate plan. It’s often possible to execute them together in a single health-
care advance directive that can also enable you to state in advance whether you want to donate organs at death and also
nominate a guardian of your person should one be required. These days, planning for the day when you might not be able to
decide for yourself should be regarded as an essential component of any estate plan.