The Living Will-Establishing Your Medical Decisions

A living will is not about who inherits your stocks and bonds when you die and it doesn’t designate who gets the family home or your mother’s jewelry. What a living will does is establish your wishes about what happens to you should you become terminally ill or permanently incapacitated. A living will is a binding set of advanced medical directives that dictates whether you will be kept alive via life support devices, or whether and when to pull the plug on those devices. Having a living will in place means that you make your final decisions rather than depending on your relatives or the state to make them. It can save turmoil and confusion over what you might have wanted, and it can spare your children or other heirs from having to make judgments they would rather not have to make.

What happens when you cannot speak for yourself? If you have not explicitly left instructions in the form of a living will, you are entirely at the mercy of others. Any number of events – a car accident, a heart attack or a blood clot, for example – can render a person permanently unable to speak and act on their own behalf. You might be allowed to die when you wished to be resuscitated or you might be kept alive through artificial means when you wished to be allowed to die. In a worst case scenario, you could even become an unwilling pawn in moral and legal arguments between competing political entities.

The Terry Schiavo case in Florida, which played out over the past decade and resulted in Schiavo’s death, provides a sad and gruesome illustration of the need for a living will.

• Schiavo’s ex-husband asserted that she had indicated, at some point during their marriage, that she would not want to live in a permanent vegetative state.

• Her parents wanted to keep her alive and argued that her, and their, Catholic beliefs precluded removing life support.

• The case was in and out of court with suits and counter suits that went on for years while Schiavo unknowingly awaited her fate in a nursing home.

• Conservative activists weighed in on the right to life and liberal activists weighed in on the right to death.

• Everyone from the Governor of Florida to Pope John Paul II and the worldwide media argued about Terry Schiavo.

• Ultimately, the ex-husband won the day in court; Schiavo was disconnected from the feeding and hydration tubes, and she slowly starved to death while the world kept vigil.

Can you prevent something similar happening to you? While the Schiavo case is an extreme example, many families go through some version of the same agonizing process when someone they love is either devastatingly ill or injured. In truth, only you know what your last wishes really are – until and unless you put them in writing in the form of a living will. Here’s how it works:

• A living will only becomes effective if you are terminally ill or permanently incapacitated. Laws in most states direct that two doctors determine when a situation is hopeless.

• You have the right, under common law, to refuse any unwanted medical procedure, including insertion of a feeding/hydration tube. Conversely, you also have the right to receive the same lifesaving medical procedures.

• Even when doctors believe that there is no hope of recovery, they are bound by medical ethics to provide lifesaving procedures until a court order directs them otherwise.

• Both the medical community and the courts, however, must abide by your pre-determined wishes, if they are written down in the form of a living will.

• Families do not have to guess, second-guess one another, or spend the rest of their lives with doubts and regrets, if they know they are following your express wishes.

How do you go about making a living will? Ideally, the best option is to consult an attorney and have a legally unchallengeable living will prepared. However, there are numerous Internet sites that provide forms and instructions for creating an adequate living will that will hold up in any state court. The pertinent question isn’t really whether or not you need a living will, but how soon you can put one in place.