Making Your Wishes Known: A Living Will
A living will is a written statement that you do not want life-prolonging medical procedures when your condition is hopeless and there is no chance of regaining a meaningful life. Living wills have been around since 1976, when California passed what is called the Natural Death Act. Although called “wills,” they have nothing to do with property, but rather with one’s self, and are intended to take effect when you are still alive. An outgrowth of concern over the loss of ability to direct medical care at the end of one’s life, a living will is an advance directive and is operative only at the time you are terminally ill and are unconscious, or are otherwise incompetent to discuss and decide with your physician what treatment you wish.
Not only a tool to control the extent and type of medical care you receive at the end of your life, a living will can also help reduce the emotional stresses and strains felt by both your family and your doctor, who must decide whether to withhold, withdraw, or continue medical treatment that cannot cure or reverse your terminal condition.
By 1989 thirty-eight states and the District of Columbia had passed some form of law authorizing a person to make his or her own decisions about dying: “natural death acts,” “death with dignity acts,” “medical treatment decision acts,” “right-to-die acts,” and so on. The laws vary in detail from state to state, so be sure to find out the limitations of yours, including:
- Whether more than the standard two witnesses are required, and if notarization is mandatory
- Whether implementation of the living will is prohibited if you are pregnant
- Whether the withdrawal of life-sustaining treatment may include artificial feeding and hydration (This is one of the most controversial issues involved in the right-to-die movement. Many states’ living-will laws specifically prohibit the withdrawal of food and water, others allow it, and some sidestep the issue entirely.)
- Whether you must follow a particular form or are permitted to add personalized instructions
- Whether your state’s living will is valid in another state
If you reside in a state without a living-will statute, what can you do? Realize first and foremost, as Alice Mehling, former director of the Society for the Right to Die, says, “Even without a living will law, everyone has the common law right to refuse treatment.” Her recommendation is to execute a general living will form as clear and convincing evidence of what you want.
Must your hospital and doctor accept your advance directive? In The Right to Die Humphry and Wickett say that some resist obeying living wills, a refusal that in many cases has led to litigation. In point of fact, Mehling tells us that the “growing body of legal opinion is that [failure to comply with a valid living will] is grounds for battery action.”
For more information on the role of advance directives in the right-to-die issue; to obtain the appropriate living-will document to comply with your state’s legislation, or the form you should use if your state lacks a living-will law; or to get answers to individual questions concerning living-will enforcement and many other issues, contact Concern for Dying or the Society for the Right to Die .