Living will (Salem Health: Cancer)
Who executes a living will? Those establishing living wills are often people in good health who wish to make provision for their end-of-life care should they become gravely ill. However, some gravely ill people (such as a person with late-stage cancer) execute such a document after their health has deteriorated to the point that there is no hope of recovery. The person executing a living will must be of legal age and of sound mind.
Related documents: Besides a living will, it is advisable for those implementing such a document to sign a medical power of attorney (MPOA). This document, signed and notarized, should be held by a trusted friend or relative or by the person’s attorney. The MPOA authorizes a designated person or persons to make decisions relating to the an individual’s care should that person be unable to make such decisions.
Whoever holds the MPOA should be trustworthy and sufficiently objective to make informed decisions regarding treatment. The person or people holding the MPOA should have a realistic view of what the patient would want if he or she were making the needed medical decisions. It is desirable to have both living wills and MPOAs drawn up by an attorney, although standard forms for executing these documents are available at most hospitals or through the National Hospice and Palliative Care Organization.
Procedures to be specified in a living will:...
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For Further Information (Salem Health: Cancer)
Colen, B. D. The Essential Guide to a Living Will: How to Protect Your Right to Refuse Medical Treatment. New York: Prentice Hall, 2001.
Hamas, Edward A. How to Write Your Own Living Will. Naperville, Ill.: Sphinx, 2002.
Litin, Scott C., Jr., ed. Mayo Clinic Family Health Book. 3d ed. New York: HarperCollins, 2003.
Raymond, Joan. “A Guide for Caregivers.” Newsweek, June 18, 2007, 62-64.
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Other Resources (Salem Health: Cancer)
Introduction (Magill’s Medical Guide, Sixth Edition)
A living will is a legal document, often part of a three-part advance directive that also includes a durable medical power of attorney and a do-not-resuscitate (DNR) order. A living will tells what medical treatment a person does or does not want, such as artificial nutrition and hydration, mechanical ventilation, or kidney dialysis. A durable medical power of attorney is a legal document that appoints a proxy to make medical-related decisions for a person if that person becomes unable to speak. A DNR is a document that directs medical staff not to use heroic measures, such as cardiopulmonary resuscitation (CPR), if a patient’s heart stops or the patient stops breathing. Advance directives should be notarized, if possible, and a copy should be placed in a patient’s medical record. A person must be eighteen years of age to sign a living will or advance directive. Most states will do not allow the withdrawal of life support from a pregnant patient.
The concept of a living will was first introduced in 1969 when it became apparent that medical technology had advanced to a level where a person could be kept alive in a permanently unconscious state for years using artificial life support machines. While artificial life support is an important medical tool that can save lives and help stabilize patients waiting to receive other medical treatments, many people do not want to receive artificial life support if it is intended only to...
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Features (Magill’s Medical Guide, Sixth Edition)
A living will can be a simple form or a complex document describing specific treatment preferences for specific conditions. Living will forms are available at hospitals, nursing facilities, and many medical treatment centers. U.S. hospitals and nursing facilities are required by federal law to ask patients when they are admitted if they have a living will or would like to fill out a living will form. If a patient is unconscious or unable to communicate his or her wishes for medical treatment and does not have a living will, then the doctor is required to consult with family members to determine the patient’s wishes regarding life-prolonging medical care. Living will forms are also available online at state health department Web sites. In addition, a lawyer can be hired to write a living will. State laws may vary for living wills, and a living will should be written to comply with the laws in the state in which medical care is provided.
The more specific a living will is, the easier it may be for the medical care team and the family to understand what a person wants. Discussing the living will with family and doctors can ensure that the intent of the living will is understood. Copies of the living will should be placed in the patient’s medical record and shared with family members. Some living wills specify the need for two physicians to concur that the patient’s medical condition is terminal with no chance of recovery before...
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Perspective and Prospects (Magill’s Medical Guide, Sixth Edition)
The California Natural Death Act of 1976 was the first legislation to allow a patient to refuse medical treatment intended to prolong life. The same year, the New Jersey Supreme Court established the right of a dying patient to refuse medical care in the case of Karen Ann Quinlan. Quinlan was twenty-one when she became unconscious, paramedics were unable to revive her, and she lapsed into a vegetative state. She was kept alive on a ventilator for several months. Her parents requested that she be removed from the ventilator, but the hospital refused. A court order was finally issued to remove her from the ventilator, but it allowed artificial nutrition and hydration. Quinlan lived in a nonresponsive coma until 1985, when she died of pneumonia.
Another well-publicized case involved Terri Schiavo, a twetny-six-year-old woman who experienced respiratory and cardiac arrest that left her in a vegetative state. When it became apparent that Schiavo would not recover, her husband requested that her artificial life support be discontinued. Schiavo’s parents disagreed. A lengthy legal battle ensued. Without a living will, it was left to the courts to decide. In 2005, Schiavo was removed from life support and died a few weeks later.
An alternative to a living will supported by pro-life groups is a “will to live” form. The emphasis of the form is that the presumption should be for life, regardless of circumstances....
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For Further Information: (Magill’s Medical Guide, Sixth Edition)
Doukas, David John, and William Reichel. “How Advance Directives Work.” In Planning for Uncertainty: Living Wills and Other Advance Directives for You and Your Family. 2d ed. Baltimore: Johns Hopkins University Press, 2007.
Mirarchi, Ferdinando. Understanding Your Living Will: What You Need to Know Before a Medical Emergency. Omaha, Nebr.: Addicus Books, 2006.
Whitman, Wynne A., and Shawn D. Glisson. “The Wants, Wishes, and Wills of Your Medical-Legal Affairs.” In Wants, Wishes, and Wills: A Medical and Legal Guide to Protecting Yourself and Your Family in Sickness and in Health. Upper Saddle River, N.J.: FT Press, 2007.
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Living Will (Encyclopedia of Surgery)
A living will is a legal document in which patients instruct health-care providers about their wishes with respect to medical procedures should they become incapacitated. The living will and the durable medical power of attorney are two federally mandated parts of what is known as advanced medical directives.
Advanced medical directives are legal mechanisms to assure that patients' wishes with respect to a number of medical procedures are carried out in their final days or when they are incapacitated. The documents reflect patients' rights of consent and medical choice under conditions whereby patients can no longer choose for themselves what medical interventions they wish to undergo.
In 1990, recognizing the importance of patient treatment wishes at the end of life, Congress enacted the Patient Self-Determination Act (PSDA). This federal law ensures that patients admitted to hospitals, nursing homes, home health agencies, HMOs, and hospices be informed of their rights under state law to prepare advance health care directives and have the documents entered into their medical record. Each state has different requirements for the living will and the power of attorney. It is important to...
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Living Will (West's Encyclopedia of American Law)
A written document that allows a patient to give explicit instructions about medical treatment to be administered when the patient is terminally ill or permanently unconscious; also called an advance directive.
With improvements in modern medicine, the life of persons who are terminally ill or permanently unconscious can be prolonged. For increasing numbers of persons, the decision of whether to prolong life is being made in the form of a written document called a living will. The living will is one type of advance directive that may be used by a person before incapacitation to outline a full range of treatment preferences or, most often, to reject treatment.
A living will extends the principle of consent, whereby patients must agree to any medical intervention before doctors can proceed. It allows the patient to guide HEALTH CARE for the future when she may be too ill to make decisions concerning care. It can be revoked by the patient at any time. For many the living will preserves personal control and eases the decision-making burden of a family.
Forty-two states and the District of Columbia have living-will statutes that make a properly executed living will legally binding. In states that do not have a statute, living wills stand as a clear expression of the patient's wishes. Living-will statutes require that the person be legally competent to...
(The entire section is 591 words.)