Living Will and Other Health Care Directives: The Basics

The Living Will directs our health care providers about specific procedures we want or don’t want. It only comes into play if we are incapacitated and can’t express our wishes directly to our nurse or doctor. Our Living Will does not direct our family or anyone else about our property. Our Last Will and Testament (our Will) does that. Because the names are similar, however, some confusion occasionally arises.

The Living Will has a Narrow Scope.

The Living Will relates to important health care procedures that we might face, such as the need for feeding tubes, life support, and comfort measures. It isn’t a Do Not Resuscitate (DNR) Order, and it will not prevent health care providers from trying to resuscitate you. So, if you want to prevent resuscitation, you should have a DNR in your medical records and perhaps even a Medical Order for Scope of Treatment (MOST). You can get more information about the importance of a MOST in this helpful article.

In your Living Will, you can say whether you want the other health care procedures that could prolong your life. But there isn’t an option to say “it depends.” Most of us, though, don’t feel convinced that we want to prohibit life support under all circumstances. We realize that our need for life support could be temporary. And a fulfilling, quality life could follow the temporary use of life support. So we may be reluctant to say in our Living Will that we don’t want life support.

However, most of us are also certain that we don’t want to be kept on life support indefinitely. So how do we express this “it depends” attitude about life support and other procedures covered by a Living Will? Well, the Living Will allows us to leave the decision to our Health Care Surrogate. We can give our Health Care Surrogate the authority to listen to our health care providers, then decide what they believe we would choose if we were listening with them. If they think we would allow life support based on the medical report, then they will allow it. It they don’t think we would allow life support based on the medical report, then they won’t allow it. And, if they allow it, but the prospect of a fulfilling, quality life after life support becomes unlikely, they can remove the life support.

But keep this in mind: if you place the decision on your health care surrogate, they must live with the decision, and that can be difficult. Many people I’ve served don’t want to put the burden of that decision on anyone else. So they express clearly in the Living Will whether they want the procedures or not, and they accept the consequences of that decision.

The Health Care (or Medical) Power of Attorney has a Broader Scope.

While the Living Will is narrow in scope and typically relates to end-of-life health care decisions, the Health Care Power of Attorney relates to health care decisions that we might face at other times in our life. Of course, like the Living Will, the Health Care Power of Attorney isn’t needed if we can express our wishes directly to our nurses and doctors. But when we can’t, such as if we are in the middle of a medical procedure, the Health Care Power of Attorney gives our Health Care Surrogate authority to make health care decisions for us. For example, imagine we are having a surgical procedure for which we must be asleep. While we’re asleep, the surgeon discovers something unexpected and knows immediate action should be taken. But the physician may be reluctant to proceed without authorization. So the physician could explain the situation to the Health Care Surrogate, get approval to proceed, then take the action without further delay. Suffice it to say, we should all have a Health Care Power of Attorney that names a Health Care Surrogate we trust to make wise decisions for our health.

You Should Have a Living Will and Other Advance Directives.

Make no mistake that I believe everyone should have up-to-date and thorough health care directives, such as the Living Will and Health Care Power of Attorney. Also, if we don’t want to be resuscitated, we should be clear to our nurses and doctors that they should place a DNR order in our medical record. And everyone should consider the Medical Order for Scope of Treatment (MOST). It will help give our nurses and doctors a clear picture of our wishes in a way that is easy for them to understand. Contact us for help with your Living Will, Health Care Power of Attorney, or other estate planning needs.