There are many reasons to make a living will: to give guidance to doctors and health care surrogates, provide clarity and closure to your loved ones, prevent conflict or disagreements among family members, and limit the emotional burden on your closest people at the time of your death. Most important is that you remain the captain of your own ship, with the authority to dictate how you want to live and die. Considering that the majority of dying people are unconscious, in distress, or otherwise not able to speak, the living will serves as your voice when you may not have one.
Despite all these reasons, not many Americans have a living will. Well under 40% of U.S. adults have created a living will (or similar document). That means that 60% are rolling the dice on who will be making decisions for us at the end of our lives. 25% report never having thought of end-of-life planning at all. Some simply do not know what the living will is or how it works.
A living will is a written, legally binding document that informs your doctors about your preferences for medical care at the end of life. Because these are legal documents, you may use a lawyer to help you understand and write a living will. However, you do not need to. With a little research and reflection, you may create your own living will with ease and for no cost.
Every state has different laws and practices, so please be sure to use a living will that your state recognizes. Some use standard forms, some allow you to draft your own. And be sure to follow your state’s rules about what kind of witnesses you should use and whether the document needs to be notarized.
What to include in your living will
In general, your living will may have:
- A standard direction that you do not want life-prolonging procedures administered or continued if there is no probability of your survival.
- More specific directions about what care you do or do not want (for example, dialysis, mechanical ventilation to assist with breathing, artificial hydration and nutrition or CPR).
- Anatomical gift decisions (meaning, whether you wish to be an organ and tissue donor or donate your body to science or education).
- Palliative care wishes (like whether you wish to die at home or avoid invasive tests or procedures).
- Spiritual and religious considerations (your faith may have its own directions for how to create a living will).
Some people are concerned that doctors will not provide medical care if they have a living will. But remember: This is intended only to be an end-of-life document. It does not prevent routine medical treatment or care for conditions that are not life-threatening.
Your living will is not a script, however. One document can’t anticipate every possible scenario and dictate exactly how things will go. Instead, consider it more of a conversation (and that conversation may change over time, because your feelings about death may be different when you’re in good health than after a diagnosis of a terminal condition or debilitating disease).
It’s best to create a living will early, when you are clear-headed. You can always review and update it as needs and conditions change.
As you do this, talk to your doctors about your wishes. Have them put your living will on file. Also speak with your closest family and friends, particularly the ones who may be your caregivers one day, so they know what your wishes are. Having these talks and writing your living will ensures that you live according to your own terms until your last breath, while giving your loved ones a sense of peace when it matters most.
Healthcare Advanced Directive Form, courtesy of UAB