What is a living will?

This document contains your wishes for end-of-life care, including life support and other medical decisions.

Elissa

Elissa Suh

Published October 23, 2019

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KEY TAKEAWAYS

  • A living will is also known as a medical directive or health care directive

  • You can make decisions about medical care, like life support and life-sustaining treatment

  • A living will differs from a health care proxy (medical power of attorney), another advance directive

  • Living wills can cost nothing if you do it yourself. States often have suggested templates

A living will is a legal document that specifies what kinds of health care you want to receive if you become incapacitated and can’t make decisions for yourself. It contains your wishes for end-of-life medical care, including when to prolong your life through life support devices and life-sustaining treatments. It is not the same as a last will and testament, which describes who should get your valuables and belongings.

Many people create a living will because they’re suffering from a terminal illness and don’t want to burden their families. However, it’s important to have a living will in place even if you’re healthy. While grim or distressing to think about, end-of-life situations are an important part of estate planning as you prepare for the future. A living will can give you peace of mind and your family a more reliable way to navigate through difficult circumstances and make the proper health care decisions regarding your care, based on your wishes.

In this article:

What is a living will?

A living will is a document containing instructions for your future medical care when you’re unable to make decisions. The terms of the living will are set entirely by you. This includes when the living will comes into play. For example, you might specify that the living will applies when you are in a coma or vegetative state but not when you’re terminally ill or have Alzheimer’s disease.

You can also describe the situations where you would accept or refuse medical treatment that is meant to prolong your life. Furthermore, you can determine what kind of treatment. For example, you might specify in your living will that you wish to be removed (or not be removed) from a ventilator — a machine that helps you breathe — if it’s the only thing keeping you alive.

Living wills are a type of advance directive, since they contain directions for the future. You might see a “living will” referred to as a “medical directive” or “health care directive” as well.

Limitations of a living will

The living will is an important part of advance care planning, and it can help ease unnecessary suffering or guide treatment according to the way you feel most comfortable. But they’re not always useful if your doctor isn’t aware that you have one.

In the case of emergency medical treatment, the doctor sometimes needs to make a quick decision about your care without seeing the living will or consulting with your family. (This is typically why DNR orders are completed by your doctor; more on that later.) For that reason, living wills are most useful for scenarios that occur over longer periods, such as deciding whether to begin surgery or treat an illness with a powerful pain medication.

To avoid this scenario, you should inform your doctor and health care providers ahead of time if you have a living will, and give them a copy of it.

What is the difference between a will and a living will?

A living will is distinct from a last will and testament. A will describes how your personal property and assets should be distributed after you die. A living will provides instructions on how and when you should receive medical care. It does not deal with assets, beneficiaries, or inheritances in any capacity. Both a will and living will are essential estate planning documents that everyone should have.

Living trust vs living wills

The only similarity between a living trust and a living will is the word “living” in the name. A living trust is simply a trust that takes effect while you’re alive and allows your assets to be distributed to your heirs according to its terms. A living trust may be either a revocable trust or an irrevocable trust.

What is included in a living will?

State laws usually guide what kinds of information living wills must contain and may provide a suggested template, but you aren’t required to use it. While one living will may differ from the next, these are the types of information you can expect to find.

Life-sustaining medical care

You must decide under what circumstances your life should be prolonged and by what measures.

Common life-sustaining treatments include:

  • Dialysis
  • Intubation (tube feeding)
  • Mechanical ventilation (breathing machine or respirator)
  • Resuscitation (CPR or defibrillator)
  • Antibiotics
  • Blood transfusions

You can consult with your physician to learn more about these treatments.

You have probably heard of a DNR, or “do not resuscitate” order, which states that you don’t want your heart to be restarted. A DNR order can be part of your living will, but it typically needs to be completed by your doctor or medical provider.

Hospice and palliative care

Palliative care (comfort care) focuses on pain management when you’re terminally ill. You can consent to receiving pain medication at all times, even if it accelerates death. You can also state whether you prefer to receive care at home or in the hospital.

Organ and tissue donation

You choose to make an organ donation for people who need transplants, or donate your body for research or education purposes. The living will can also state that your wishes to undergo an autopsy, even when it is deemed unnecessary.

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Medical power of attorney

The power of attorney (POA) is a legal document that authorizes someone to act on your behalf. This person is called the agent. A power of attorney for health care allows someone to make medical decisions for you when you cannot do so yourself.

A living will is mainly intended for end-of-life, whereas medical power of attorney is meant to cover a broader range of medical care. (Both are examples of advance directives.) For example, the person who you granted as medical power of attorney can make decisions while you are temporarily in surgery, not just when you are in a coma. The agent should follow your living will if you have one.

The health care proxy is typically its own form, separate from but often included with a living will. Every state has their own health care proxy form.

Sometimes, a living will with a health care proxy together is referred to as an advance medical directive.

How to write a living will

A living will doesn’t need to be a long document, but it can be helpful to be as detailed as possible if you have specific wishes. You can ask a lawyer to help you create one, to make sure it’s ironclad and covers all of your wishes.

As previously mentioned, many states provide their own templates for living wills and advanced directives, which you can use for free. You can also use an online will service to help you create one as well. The costs to create a living will using an online service can vary.

Once you fill out the paperwork, the living will still needs to be signed by two witnesses and notarized. Who is eligible to be a witness depends on your state; for example, some states may prohibit witnesses that are immediate family or your agents. Witnesses must also be of a certain age. In Vermont, your witnesses must be at least 18 years old, but in Texas, they can be as young as 14.

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