Living Wills Essay, Research Paper

Living Wills, sometimes called Advanced Directives, are legal documents accepted in all 50 states. They clearly define a person?s wish to decline life-support or medical treatment in certain circumstances, usually when death is imminent. Generally, a living will takes effect when a person becomes terminally ill, permanently unconscious or conscious with irreversible brain damage.

A living will also allows a person to state with particularity the forms of treatment are wanted and not wanted. For example, if a one does not want artificial life support, then sign the living will stating that desire. It is also important to discuss your beliefs and wishes with you family, spouse and other people whose opinions you respect, such as clergy, physicians, attorney or an accountant.

Living wills are recognized in every state, but each state has different requirements. If someone is interested in making a living will, contact an expert in the state that you live in, such as a hospital, local agency on aging or local bar association. To help ensure that the living will be honored, give copies to family members, physicians, lawyer and other involved in caring for the person?s welfare.

Federal law now requires most health care facilities (hospitals, nursing homes, HMOs and home health agencies) to ask patients if they have a living will or would like to complete one.

Can Medical Care Legally Be Stopped If There Is NO Living Will?When there is no written document, a spouse or close family member may still request that treatment be withheld if the patient cannot do so, but the request could be denied. The way states and health care providers handle such cases varies widely. Typically, a doctor or hospital representative will meet with a person?s family to discuss what that person?s wishes were. In some cases a health care facility may want to withhold or provide life support against a family?s wishes. In some cases a formal hearing may be held to determine how to proceed.

How To Make A Living Will The rules for preparing a living will vary from state. Some states require that the document be signed with the same formalities required for execution of a will, but many state recognize the effectiveness of more informal declarations. Generally a living will:

Should Be in Writing.

Should Be Signed and Dated.

Should Be Signed Voluntarily

Should State Specific Treatments

It is evidence of the patient?s wish, and it is the patient?s wish that has legal force, not the document. Living wills cannot request euthanasia or unreasonable treatment. Living wills, once activated, should ensure that your physician and the medical facility uphold your health care treatment beliefs and wishes. Your family or your physician cannot revoke them; your living will can only be revoked orally by you or by court acting on your behalf. With a living will, you maintain control over your end-of-life decisions. If your wishes are explicitly stated in your living will, your doctor and your family should not be able to supersede them. As long as your wishes are known, they should be respected.

Limitations to the Power of a Living WillRemember that living wills only become active when the patient becomes terminally ill ? when death is imminent and the patient can no longer communicate his/her wishes to their physician, spouse, or family. Living will DO NOT become active immediately after you sign them.

It is important that one discuss their feelings about health care options with their physicians. Many doctors are not yet comfortable with the idea of living wills so they may be hesitant to encourage their patients to consider the alternatives options and issues surrounding living wills and health care options.

In addition, the legality of living wills is still being challenged in about 25 percent of all cases, decisions are made -? by family or physician ? that are contrary to the patient?s wishes as stated in their living will (i.e. the court determined that the patient?s death was not imminent, therefore, the constraints and treatment preferences stated in the living will were not yet activated). However, living wills are preferences stated in the living wills are gaining legal power in the eyes of the U.S. Supreme

Court reaffirmed the constitutionality of honoring a refusal of treatment and stressed the difference between types of end-of-life decisions and physician-assisted suicide.

The living will can be written or oral. It must not have been made under pressure or coercion. The person must have been competent of that time to make the decisions involved. (This is presumed unless there is evidence to the contrary.) Note: a person may have a mental illness and still make a valid living will as long as they understood the implications of what they were doing. Competency means competent to make the decisions in question, not necessarily competent to make other decisions (such as, relating to financial affairs). If the living will applies exactly to the circumstances that subsequently arise, health care professionals must follow it. If it does not apply exactly, by describes a general wish, then the health care team should consider it among other evidence of what the patient would wish. Relatives may also be able to supply information on the patient?s wishes. Having gathered all the information, a health care decision should be made on the basis of the patient?s best interests with due regard to their wishes, as well as these can be determined.

Writing Your Own Living WillWhen signing a Living Will make sure that a statement is enclosed specifying your ?WISHES? about the extraordionary measures to be taken to keep you alive if you become permanently unconscious or terminally ill.

Make sure you express your beliefs fully and as explicitly as possible. It is strongly recommended (but not essential) that you consult an attorney when writing a living will. Your attorney will best be able to help you develop your health care preferences and beliefs into a document that clearly states your wishes. If you do not have an attorney and still plan to write your own living will, consider obtaining a copy of a living will form from your state health department, local hospital, local Area Agency on Aging, or physician. You can use the living will form as a guide to help you think about and formulate your ideas concerning your preferences.

When developing your living will, you need to think about possible treatments that you may or may not wish to receive under various conditions.

Some treatments you may wish to withdraw only in certain circumstances, others you may always wish to receive. Your living will should clearly state how you feel about receiving certain types of treatment in various health-care situations. Some of the options are explained below:

DNR ? ?Do Not Resuscitate? order (DNR) simply states that if you are deemed by a physician to be terminally ill, you do not wish to receive cardio-pulmonary resuscitation (CPR) if your heart stops beating or you stop breathing. You feel that CPR will be futile or will serve to only prolong your life.

Surgery ? If you become terminally ill, you may not wish to have surgery, es-pecially if that surgery is elective or if it life-prolonging in the case of imminent death. For example, a terminal cancer patient may not wish to have minor surgery, such as a tonsillectomy if they have tonsillitis. If you are writing your own will, you may want to make your wishes regarding surgery case specific, you have the ability to state what YOU want.

Pain Medication. A living will should address the types of medication you wish to have administered and under what circumstances.

Respirators ? Respirators are a means of artificial respiration for patients who cannot breathe on their own.. If you disagree with the means or ?artificial? medical treatments, these should be address in the living will.