What is a Living Will
“If not now, when? If not you, who?” Hillel the Elder
A few months ago, I had to deal with a heart-breaking situation.
A client of one of the professional guardians for whom I do legal work was quite ill and then had a heart attack. When I got involved in the case, she was in a coma and was probably terminal. She did not have a Living Will, and sometime in the past, before she got sick, she had told her partner that she wanted doctors to do everything necessary to keep her alive.
Now it was very doubtful that she would ever regain consciousness. The doctors felt they were ethically obligated to keep her alive and wanted to perform heart surgery on her. They admitted, however, that the surgery would probably kill her, but they didn’t want to have to be the ones to make that decision.
Who then makes this difficult decision? Family? Loved one? Her partner? Her Guardian? Answer – None of the above.
In this case it was up to a court-appointed commissioner.
My job was to prepare two petitions for the court.
Direct the doctors to perform surgery, which would be expensive and probably kill her anyway, or
Give her palliative (comfort) care and let nature take its course.
In this case, I believe the woman made her own decision, because she died the night before the court hearing.
According to Washington State law, an Advance Health Care Directive or Living Will, is a “directive to withhold or withdraw life-sustaining treatment.” A reaction to rapid changes in medical technology and to the social debate regarding the artificial prolongation of life, it provides instructions to healthcare providers and to the family and loved ones about whether or not to pursue life-sustaining measures should a person become “terminal” or in a “permanent unconscious” condition. The law contains specific enforcement provisions that protect the wishes of the patient.
Along with a Health Care Directive, as part of an estate plan, it is wise to include a Health Care Power of Attorney. This allows the client to choose someone, usually a loved one or trusted friend, to responsibly carry out and manage the healthcare decisions should that client become incapacitated. Between the two documents the wishes of the client are honored. The burden of having to make a life or death decision is also lifted from a loved one, the family or a friend or even the court system.
Living Wills and Health Care Powers of Attorney are part of a good estate plan. The process is fairly simple, and it provides a good opportunity to have the discussion with the family about end-of-life decisions.
