The term ‘living will’ is commonly used to describe what is known as an ‘advance directive’ in Scotland or an ‘advance decision’ in England, Wales, and Northern Ireland. This document serves as a written record of your preferences for medical treatment that you may or may not desire in the future. Its activation occurs when you lose mental capacity or are otherwise unable to communicate your wishes effectively. Living wills have grown in popularity as a crucial component of estate planning. It is essential that the document accurately and clearly conveys your wishes for future medical treatment, therefore it is recommended that you seek the help of a solicitor in drafting this document.
What types of decisions does a living will cover?
A living will allows you to express your preferences regarding emergency treatments aimed at sustaining life. Discussions with your health care proxy are also crucial in ensuring your choices align with your values. The decisions that may arise in this context include:
- CPR (Cardiopulmonary Resuscitation): This involves chest compressions, artificial respiration, defibrillation, and medications to restore a heartbeat. It is essential to note that the effectiveness of CPR diminishes with age and the presence of chronic medical conditions.
- Ventilators: In situations where breathing is impaired, a ventilator may be necessary. This machine aids breathing by pushing air into the lungs through a tube. Intubation, a potentially uncomfortable process, may be required, and in long-term cases, a tracheotomy may be performed for more comfort.
- Pacemakers and ICDs (Implantable Cardioverter-Defibrillators): While pacemakers regulate heartbeats, ICDs can restore irregular rhythms. Your living will should specify your preferences if these devices are in place and whether you wish to continue their use.
- Artificial Nutrition and Hydration: If you cannot eat or drink, fluids and nutrients may be administered through IV or a feeding tube. Your living will should clarify your stance on these measures, considering factors like short-term or long-term use.
In addition to medical decisions, your living will allows you to document other important preferences, such as organ and tissue donation and brain donation.
How to prepare a living will:
- Reflect on values and wishes: Consider what matters most to you at the end of life. Reflect on your goals, whether it involves pursuing every available medical intervention or choosing a specific quality of life.
- Consult with a doctor: Discussing advance care planning with a healthcare provider can help you understand potential scenarios and make informed decisions. This conversation may not be covered in annual health visits.
- Prepare a Living will either by yourself or with the help of a solicitor Store the completed form in a secure place and provide copies to your health care proxy and healthcare provider. Inform your General Practitioner (GP) and consider placing a copy of the living will on your medical records for convenient reference in the future.
- Regularly update your living will: Reevaluate your living will at least annually and after major life events, such as a divorce or relocation, as your preferences may evolve over time.
- Immediate Relatives: Share the details with your immediate relatives, as they may be consulted about your medical treatment if you are unable to communicate your wishes. Ensuring your family is aware of your preferences is paramount.
- Inform your Welfare Power of Attorney: If you have appointed a welfare power of attorney, make sure to notify them. They play a key role in decisions about your medical treatment in case of capacity loss.
What distinguishes a power of attorney from an advance decision?
In contrast to a Lasting Power of Attorney, an Advance Decision or Living Will lacks the capability to provide directives for your overall day-to-day care or empower your loved ones to make decisions regarding your welfare. Specifically, an Advance Decision can only articulate the treatments you wish to refuse, as opposed to specifying the treatments you would like to receive.
It is entirely feasible to possess both an Advance Decision and a Lasting Power of Attorney. However, the authority of the attorney to override the Advance Decision is contingent on two conditions:
- The Lasting Power was created subsequent to the Advance Decision, and
- The LPA explicitly grants the attorney the power to override the Advance Decision, provided they believe it is in your best interests.
In instances where you have both an Advance Decision and a Lasting Power of Attorney, it is imperative to inform your attorney about the existence of the Advance Decision and furnish them with a copy of the document. This ensures that your preferences and choices are communicated effectively, contributing to a more comprehensive and informed decision-making process.
Feel free to contact me if you’re considering integrating a living will into your estate plan. . I can guide you through the process, ensuring your living will aligns seamlessly with your intentions and meets legal requirements.