You know you should prepare for certain health and medical contingencies such as incapacitation or terminal illness and make it clear whether you want resuscitation or not. But it’s hard to sort through all the confusing medical terms and legal jargon. One particular area of confusion is that surrounding a living will vs. advance directive.
Broadly speaking, an advance directive is a set of instructions about future medical care should you become incapacitated and unable to make your own decisions or articulate those decisions. A living will is a species of advance directive that more specifically spells out your wishes concerning medical care, often in the event of terminal illness. So let’s take a look at advance directives first.
Advance directives consist of both oral and written instructions concerning what you want in medical care if you are rendered unable to make or to communicate those wishes. They guide doctors and other medical professionals according to your wishes in the case of, say, dementia, serious injury, or coma. Further, advance directives are not unalterably set in stone. You can revise or update them as you see fit. The purpose of advance directives is to reduce confusion and disagreement about medical care choices and to keep your family from having to make these decisions for you during a difficult time.
Also, an advance directive can grant a medical/healthcare power of attorney to the person you designate to make your medical care decisions when you can no longer do so. Although laws here vary slightly from state to state, this person can be a spouse, other family member, or friend, and you can also designate alternates. The importance of a person with the power of attorney to act as your proxy consists of the fact that not all situations can be anticipated and spelled out in the advance directive. You will have, then, someone to make judgment calls and decisions if that becomes necessary.
Now, a living will is a formal, written legal document that does much of what an advance directive does, but it is a little more specialized and specific because it is a type or species of advance directive. It clearly delineates what medical treatments you do and do not want in the event of incapacitation. It also addresses related concerns such as organ donation and pain management. Here some of the possible areas of coverage of a living will:
Resuscitation if your heart stops (or a do-not-resuscitate, DNR, clause)
Mechanical ventilation if you can’t breathe on your own (or not)
Intubation for feeding if you are unable to eat
Dialysis in the event of kidney failure (whether and for how long you want it)
Aggressive (or not) antibiotic and/or antiviral treatment (usually in terminal situations)
Extent of palliative/comfort care
Tissue/organ/body donation (or not)
So the main difference between a living will and an advance directive is that the advance directive is broader and more inclusive, thus giving you more options. It also allows you to name a health care agent to make decisions and act on your behalf.
An advance directive and a living will are not just for the elderly because sudden, end-of-life situations can happen to people of any age. It’s important, then, to have these legal documents drawn up well ahead of time by a qualified attorney so that you will be prepared for the worst and the inevitable now. You just never know what the future holds. At Legacy Law Group of Northern Virginia, we specialize in advance directives, living wills, power of attorney, and estate planning.