A Living Will: the treatment you want, written down

A Living Will states what medical treatment you want — and what you do not want — if illness or injury leaves you unable to say so yourself. It is also called an advance directive or a health care directive; the three names mean the same document.

It is not a Will. A Last Will decides who receives your property after you die, and speaks only then. A Living Will speaks only while you are alive, and only when you cannot speak for yourself. Most people need both, for entirely different reasons — and here they come together: your Living Will and Medical Power of Attorney are included with your Will at no extra charge.

The three choices it records

1. Whether your life should be prolonged

   Whether you want treatment to continue when you are diagnosed with an incurable disease that will cause death within a short time, when you are unconscious with no reasonable expectation of waking, or when the risks and side effects of treatment outweigh what it can be expected to achieve.

2. Artificial nutrition and hydration

   Whether you want to be fed and given fluids by tube once you can no longer eat or drink. Many people who decline other treatment still want this, and many do not. The document records which you chose rather than assuming either way.

3. Treatment to relieve pain

   Whether you want pain relieved at all times, even when the medication needed to do it may shorten your life. It is the question people find hardest, and the one most often left unanswered until the room where it finally matters.

What happens without one

• The decision goes to whoever is available — usually your family, sometimes the doctor on duty.
• The people deciding may not be the people you would have chosen, and they may not agree with each other.
• With nothing written down, treatment continues. That is the default in medicine, and it is not a decision anybody makes.
• A disagreement your own words would have settled is argued out at the worst possible moment.

What it does not do

• It does not distribute anything. Who receives your property is the Will’s business, not this document’s.
• It does not appoint anyone to speak for you. That is the Medical Power of Attorney, a separate document, and the person it names is the one who talks to the doctors.
• It is not a Do Not Resuscitate order. A DNR is a medical order a doctor signs; this is a legal instruction you sign.
• It says nothing about what happens after you die.

What comes with your Will

• A Last Will and Testament — who receives what, who carries it out, and who raises your minor children.
• A Living Will — the treatment choices you make, written the way a hospital expects to read them.
• A Medical Power of Attorney — the person who speaks for you when you cannot, and the authority they have to do it.
• Signing instructions, and an affidavit page for a notary to complete where one is wanted.

One document cannot do the work of the other two. A Living Will without a Medical Power of Attorney leaves your instructions with nobody appointed to apply them, and a Medical Power of Attorney without a Living Will appoints someone to speak without telling them what you want said. That is why the package is all three, and why the price is the same whether you need one of them or all three.

Making it count

Sign it the way your state asks for. A Living Will is signed in front of witnesses, and a beneficiary of your Will should not be one of them. The instructions that come with your documents say what to do, and the affidavit page is there for a notary to complete where one is wanted.

Then tell somebody it exists. Give a copy to the person you name in your Medical Power of Attorney and one to your doctor, and keep the original somewhere it can be reached in a hurry — a document nobody can find is a document that does not work. You can replace it at any time by signing a new one.

If you would rather see the questions before paying for anything, our free Living Will form asks the same three and needs no account. It is the same document at the end, and it is the quickest way to find out whether this is a decision you want to have made today. If you want the wider picture first, the questions people ask us covers the notary rule and the rest.

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