LIVING WILLS and ADVANCED DIRECTIVES
A living will is a brief declaration or statement that a person may make indicating their desire that certain medical treatment be either withheld or withdrawn under certain circumstances.
A living will or any other advanced directives should always be prepared in advance of any hospitalization or impending surgery.
Living wills are limited under Missouri Law to situations involving a “death-prolonging procedure” and “terminal condition” which are both defined as a condition where death will occur within a short period of time whether or not certain treatment is provided. In other words, the patient will die shortly with or without artificial resuscitation, use of a ventilator, artificially supplied nutrition and hydration or invasive surgical procedures. Thus, a living will only avoids treatment when death is imminent and the treatment is ineffective to avoid or significantly delay death.
A patient who wants to give instructions which exceed the limitations of a living will needs an advanced directive. An advanced directive is an instruction by a patient as to the withholding or withdrawing of certain medical treatment in advance of the patient suffering a condition which renders the patient unable to refuse such treatment.
A competent patient always has the right to refuse treatment for himself or herself, or direct that such a treatment be discontinued. However, without an advanced directive, once a patient becomes incapacitated, he or she well lose that right.
Advanced directives must be clearly written and may include instructions to withhold or withdraw artificially supplied nutrition and hydration or other treatment or machinery which may maintain a patient in a persistent vegetative state. Directives can be tailored for the specific needs of the patient as well.
Once the documents have been signed, they should always be kept close at hand and not in a safe deposit box. You should provide copies to your attending physician, your health care power of attorney and relatives. If you are hospitalized, a copy should go into your medical records.
An advanced directive will give very important guidance to your attorney - in fact as to how he or she should act.
You accomplish at least two things by giving advanced directives, regardless of whether they direct all possible treatment or only some treatment.
First, you ensure that the treatment you receive is the treatment you desire, no more and no less.
Second, you take the burden off of your family and friends to make those decisions for you at a time when they will most likely be emotionally upset by your critical condition. Finally you may be avoiding litigation to determine what treatment you really desired or intended.
Every estate plan should include a living will and an advanced directive.