LIVING WILLS AND ADVANCED DIRECTIVES – FAQ

Living will lawyer St. Peters

LIVING WILLS AND ADVANCED DIRECTIVES – FAQAre a living will, advance directive and healthcare directive all the same thing?

Practically yes.  That’s because each document, regardless of title, lays out instructions for your healthcare power of attorney to follow if you are persistently unconscious, terminally ill and/or otherwise seriously incapacitated and cannot makes healthcare decisions for yourself.

What’s the point of having a living will?

To leave instructions for the people you love and who care about you as to what treatments you want to have withheld or withdrawn if you are near the end of life.  If you’re not able to tell your doctor that you don’t want to have an invasive surgery or artificially supplied nutrition (life support) in the event that your doctor believes it will only prolong your life rather than help you recover, the document tells your agent (your power of attorney) to withdraw those treatments, and others, such as chemotherapy, a respirator, dialysis, antibiotics.

Antibiotics?  Why wouldn’t I want that?  I don’t want to die from an infection.

Let’s say you had a terminal illness.  You are hospitalized for a long period of time due to that terminal illness and develop sepsis.  Sepsis occurs when your body releases chemicals to treat an infection which can trigger inflammation throughout your body, causing organ systems to fail and sometimes can lead to death.  Now normally sepsis would be treated with antibiotics. But for someone with a terminal illness, say brain cancer, having antibiotics administered to treat sepsis may end up killing off the sepsis but suffering more and, in any case, with no hope of recovery from terminal brain cancer.  

Most people don’t want to suffer in silence and prolong the dying process.  

Can’t my family just “pull the plug”?

Pulling the plug is a euphemism for something different called euthanasia.  Euthenasia is different because it means directly ending someone’s life through active means, like a shot.  That is only legal in a couple of states and only under certain conditions.

The healthcare directive, however, does allow treatments that would normally save you to be withheld or withdrawn so that your death occurs faster.  It’s different but also designed, like euthanasia to allow people to avoid pain and suffering and to pass away with dignity, if possible.

I don’t want certain family members to be making these serious decisions, so how can I fix that?

That’s the point of creating a healthcare power of attorney and living will.  You are appointing an agent, a power of attorney, to make healthcare decisions for you and in the order that you want.  If you don’t have this document, your “next of kin” who are there can all make decisions for you equally. That’s not good.  First, you want to be able to specify who, and perhaps only who is in charge. Second, you don’t want your family fighting over a disagreement about the right steps to take for your health and well being.

What if my agent doesn’t follow my wishes and prolongs my life, against my stated wishes?

That could happen and that’s because your instructions in your living will have to be executed by your agent.  They can’t be executed independently by your doctor or the hospital itself. That’s why it’s so important that you create the document and name someone in your healthcare power of attorney that you trust to care out your wishes.  

Is a healthcare directive the same thing as a healthcare power of attorney?

In Missouri, they are separate but can be two parts of the same document.  At our firm, Part I is the healthcare power of attorney, which allows you to pick who is in charge if you are incapacitated and who will carry out your instructions in your living will / healthcare directive which is Part II of the same document.  

What if I want my entire family to decide together?

As the saying goes, “too many chiefs and not enough Indians” can cause disagreement, anger, delay and ultimately, that goes to your comfort and your quality of life.  As I always like to remind clients, in most families, even if you have one person in charge, that person will ordinarily consult with other family members. They certainly don’t have to, but in the usual situation that’s exactly what happens, so you get the benefit of everyone’s input without everyone having a final say.  

What are the different treatments that I can have withheld or withdrawn?

  • Artificially supplied nutrition and hydration
  • Invasive surgery or procedure
  • Antibiotics
  • Respirator
  • Dialysis
  • Chemotherapy
  • Radiation
  • CPR
  • All other life prolonging medical procedures or treatments that are merely intended to keep me alive, but offer no hope of recovery from my illness.  

The last one is what I call a catch-all in that it is generic but captures the point of having a healthcare directive, in that you are trying to let your loved ones know that you don’t want to be kept alive without hope of recovery.  

What if I have instructed my agent in my living will that I don’t want to have surgery, for example, but my treating doctor tells my agent that it could help lead to my recovery?  

That’s a great question and the document contains a solution.  In a scenario where you have told your agent to withdraw everything if you are terminally ill or persistently unconscious but your doctor thinks there’s a chance that one of those treatments could lead to a recovery which is significant to you, then you expressly state in the documents we create that you want that treatment to be done for a reasonable period of time, as long as it is working.

Say for example I’ve created a healthcare directive and it’s my time to pass away and my Agent has followed my wishes to withdraw all the life prolonging treatments and procedures, what’s next?

The document specifically states that you direct that you receive medical treatment to relieve pain or provide comfort.  This is called palliative care and is designed to manage pain and other distressing symptoms.

What if I change my mind about my living will after I’ve signed it?  

Then you can create a new document in which you state you do want to have your life prolonged in the scenarios we discussed above.  No problem. The only requirement is that you have mental capacity to do so.

How can your firm help me with a living will?

We can sit down with you and your spouse if you are married and discuss who the best people to make these specific healthcare decisions are, and then we can put those choices together in the living will document and review it with you thoroughly so you understand it.

We are living will lawyer St. Peters, this is what we do every day and we can help you get peace of mind with respect to this important life issue.