Living wills are specifically written to preserve a patient’s right of
self-determination in health care when he/she is no longer able to decide for
himself/herself. A Living Will specifically provides a series of written directives to
health care givers in the event of a terminal medical condition (an incurable or
irreversible health condition that will cause death within a relatively short period of
time). The concept of a Living Will is based
on the individual's right of informed consent, the right to decide whether to accept or
forego treatment with a full understanding of the potential benefits and risks involved.
Such legal device not only preserves one’s right to continue to control his/her own care
when incapacitated, it relieves loved ones of the burden of unwanted decision-making and
prevents many of the legal and social pressures which foster continued care beyond the
time the patient would have it stopped.
In preparing a Living Will, it is essential to consider beyond a narrow definition of “terminal medical condition” and to also include those very clinical situations in which artificial life support systems are used for prolonged periods, such as persistent unconsciousness, end-stage mental deterioration (dementia), multiple sclerosis, paraplegia, extensive strokes, or end-stage lung, heart, kidney and liver failure. In preparing a Living Will, it is prudent to leave directives covering all situations in which the quality of life is so limited that the patient deems it meaningless. It takes time to develop a decision so that passage of time is recommended before signing a Living Will. As it also requires emotional commitment to deal with many separate issues, it is wise to consider how many purposes a Living Will serves in addition to preserving the patient’s right to continue to control his/her own medical care even in the unfortunate event if incapacity.