If your parents become unable to make decisions about their end-of-life care, a living will is one of the documents that can help ensure they receive the treatment they want. But it has benefits for you, too—namely, the peace of mind that comes from knowing you are following their wishes. Indeed, living wills arent just for seniors. Sanford J. Mall, a nationally certified elder-law attorney with Mall Malisow & Cooney, in Farmington Hills, Mich., explains why everyone needs one.
Q: What is a living will?
A: A living will, sometimes called an advanced health directive or a medical power of attorney, is a legally enforceable document that identifies a patient’s end-of-life wishes. It can specify that you want the cessation of treatment under a specific set of conditions—when you want to “pull the plug,” in other words. Most people draw the line in one of three ways.
- If they’re in a coma or a persistent vegetative state and there’s no hope for recovery.
- If they’re not in a coma, but have lost so much cognitive function that the doctor feels there’s no hope for recovery.
- If there’s a terminal illness with no hope for recovery.
A living will does not authorize someone else to act on your behalf for medical decisions. You need a health-care proxy for that.
Q: Who should have a living will?
A: Anybody who is older than 18 and competent. If you are sure you dont want to be put on artificial support, and dont want to have extraordinary measures used to sustain your life, then you should sign a living will. Remember the case of Terri Schiavo: Her husband and her parents fought a seven-year legal battle over removing her feeding tube, with some 20 judges ruling on whether there was sufficient evidence that she would want to stop treatment. If it had been in writing, would you need 20 judges, or all the heartache and family strife? No.
Next Page: What to include in your living will
[ pagebreak ] Q: How do you get a living will?
A: In many cases, state bar associations have forms available online. They may not be exactly what you want, but at least they’re a starting point. If you work with a lawyer, you won’t have to worry about whether the form is good or bad. Plus, you may want something very specific in your document that the form doesn’t cover; a lawyer can help you with that. Each state has its own requirements for what you need to do to make the document legally enforceable, such as the number of witnesses and who can sign as a witness. These guidelines, which can affect whether the document is legal or not, should be spelled out on your state’s bar association site. You may also be able to find living will resources at local hospice groups. Some hospitals offer the forms for patients or visitors.
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Q: What should a living will say?
A: I recommend that a living will respond broadly to what a person wants—its hard to anticipate every possible specific scenario. However, there might be individualized specifics. Take my grandmother, for instance. On the one hand, she believed that “where there’s life, there’s hope,” but on the other, she never wanted to be intubated because she had it done once and found it to be the most excruciating experience. Also, she didn’t want a doctor to perform any chest compressions on her, even if she could die without them, because she was weak and her ribs could be easily cracked. So the document we drew up for her had to take all that into account.
Q: How do you talk to your parents about getting a living will?
A: The best way to have that conversation is proactively. Have it in advance of anyone needing a living will. Even if your parents put off your initial approach, at least you’ve planted the seed. And even in states where next of kin can legally make an end-of-life decision for someone, a living will can at least let you know what your parents want. I recently had a situation where a man who had a terminal illness came to see me to do his end-of-life planning, including a living will. At his funeral, his daughter came up to me said, “When we got the call from the hospital that a decision needed to be made about Dad, we pulled out all the documents and read what he wanted. It was such a comfort knowing that he thought about these things and was specific about what he wanted.”
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