What Is a Living Will?
Thinking about medical care at the end of life isn't always easy, but making your wishes known ahead of time can help you maintain a say in your care if you're ever unable to speak for yourself.
A living will is a legal document that records your preferences for certain medical treatments if you become unable to communicate your decisions and meet the conditions specified in the document and applicable law. It's often associated with end-of-life care, particularly situations involving a terminal condition, permanent unconsciousness, or another serious medical circumstance.
A living will doesn't mean you're refusing medical treatment. It's a way to explain which treatments you would or wouldn't want in particular circumstances, so your healthcare team and loved ones have guidance when difficult decisions arise.
What Does a Living Will Cover?
A living will can explain your preferences for medical treatment if you become unable to make or communicate healthcare decisions yourself. Depending on your state's laws and the document's wording, it may address matters such as:
Life-sustaining treatment: Whether you want treatments that could prolong your life when recovery isn't expected or your condition meets criteria described in the document.
Resuscitation: Your wishes regarding cardiopulmonary resuscitation (CPR) in circumstances covered by the document. A living will isn't necessarily the same as a medical do-not-resuscitate order.
Breathing support: Your preferences regarding a ventilator or other treatments that help you breathe.
Artificial nutrition and hydration: Your wishes about receiving food or fluids through medical methods when you can't eat or drink normally.
Comfort care: Your preferences for pain relief and other measures intended to reduce suffering.
You don't necessarily need to address every treatment in detail. The purpose is to communicate what matters to you in the situations the document covers.
It's also important to understand that a living will doesn't always take effect simply because you're unconscious or seriously ill. The circumstances in which it applies depend on the document and state law, and medical professionals may need to determine whether those conditions have been met.
Why Is a Living Will Important?
If you're unable to communicate, your family and healthcare team may have to make decisions without knowing exactly what you would have wanted. That can be particularly difficult when loved ones disagree or feel uncertain about whether they're making the right choice.
A living will gives them written guidance based on decisions you've made in advance. It can help reduce uncertainty, communicate your preferences, and make it easier for others to respect your wishes.
It also gives you an opportunity to think through your choices before you're facing a medical crisis. You can consider what quality of life means to you, which treatments you're comfortable receiving, and what matters most if recovery isn't possible.
These decisions are personal. Two people with similar medical conditions may have very different preferences, and that's okay. The goal is to document your own wishes rather than choose what someone else thinks you should want.
What's the Difference Between a Living Will and a Power of Attorney?
A living will and a healthcare Power of Attorney serve related but different purposes.
A living will records your preferences for medical treatment in certain circumstances when you can't communicate your wishes.
A healthcare Power of Attorney, sometimes called a healthcare proxy or healthcare agent designation, allows you to appoint someone to make healthcare decisions for you when you cannot make them yourself, subject to the document's terms and applicable law.
For example, your living will might explain your preferences about life-sustaining treatment if you're permanently unconscious. Your appointed healthcare decision-maker may be responsible for making other medical decisions that aren't specifically addressed in the document.
Having both can help. Your written instructions provide guidance, while your chosen decision-maker may be able to respond to situations you couldn't have anticipated.
The names and legal requirements for these documents vary by state. In some places, a living will is part of a broader advance directive, while other states use different terminology or forms.
How Do You Create a Living Will?
The process depends on where you live, but there are several practical steps you can take.
Think about your wishes. Consider the kinds of medical treatment you would want in serious circumstances, including treatments that might prolong life without a reasonable expectation of recovery.
Learn your state's requirements. Check the legal requirements for creating a valid document, including signing and witness or notarization rules where applicable.
Use an appropriate form. Your state's health department, official government resources, or a qualified attorney may be able to provide guidance or forms that meet local requirements.
Talk with your healthcare provider. A clinician can explain what different treatments involve and help you understand the medical situations you may want to address.
Share the document. Give copies to your healthcare decision-maker, healthcare providers, and anyone else who may need to refer to your wishes. Ask how the document can be added to your medical record.
Review it when circumstances change. Your views may change as you get older, experience a major health event, or learn more about available treatments. Review your document periodically and follow your state's process for making changes.
Don't assume that a form found online automatically meets the legal requirements where you live. Requirements differ, so it's worth checking that the document is appropriate for your state.
Does a Living Will Replace Other Documents?
No. A living will addresses certain medical treatment preferences, but it doesn't cover every aspect of future healthcare or financial planning.
A healthcare Power of Attorney or similar designation identifies someone who may make medical decisions for you when you're unable to do so. An advance directive is a broader term used in many places for documents that record healthcare wishes and may appoint a decision-maker. The precise definitions and forms vary by state.
A financial Power of Attorney serves a different purpose: it authorizes someone to handle specified financial or legal matters on your behalf. It doesn't automatically give that person authority to make healthcare decisions.
You may also encounter a do-not-resuscitate (DNR) order. This is a medical order concerning CPR in the circumstances it covers, not simply another name for a living will.
A living will may express your wishes about resuscitation, but a DNR order generally requires a separate process involving a qualified healthcare professional.
Because these documents work together, it's worth reviewing your overall plan to make sure your wishes are documented and the appropriate people know their roles.
Final Thoughts
A living will gives you an opportunity to put your medical treatment preferences in writing before a situation arises in which you can't communicate them. It can provide important guidance to your loved ones and healthcare team during difficult moments.
You don't have to know exactly what every future medical situation will look like. Start by learning about your options, thinking about what matters to you, and documenting your wishes in a way that meets your state's requirements.
The most useful document is one that reflects your preferences, is legally valid where you live, and can be found by the people who may need it.
Up Next: A living will records your wishes about certain medical treatments, but advance care planning can involve more than treatment instructions alone. In the next article, we'll explain what an advance directive is, how it may include a living will and the appointment of a healthcare decision-maker, and how to make sure your documents work together.
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