If you are worried about the types of medical treatment you may receive at the end of your life, you should compose a living will.

Doctors have a general duty to preserve life through whatever means are available. The only way for patients to override a doctor's general duty is to leave written instructions for their preferred medical care in case they become incapable of expressing those wishes. If you are worried about the types of medical treatment you may receive at the end of your life, you should compose a living will. A living will, also referred to as a healthcare directive, is not a part of the will that a person uses to pass property at death. It is a separate document that lets your loved ones know what type of care you do or do not want to receive should you become terminally ill or permanently unconscious/in a vegetative state.

MAKING A LIVING WILL

The United States Supreme Court has ruled that all capable adults have the right to refuse medical care if they so choose. As long as there is clear and convincing evidence that someone who is unable to communicate would have wanted to refuse medical treatment, a court must honor such wishes. Some states have adopted laws to provide for health care proxies or other documents that can be deemed clear and convincing evidence of a person's health care wishes. A health care proxy designates a person to speak for you in the event that you are unable to communicate your health care decisions.

All states requires that the person making a living will must be "legally competent," which is defined as capable of understanding what the document means, what it contains, and how it works. You must sign the document as a way of verifying that you understand it and that it contains your true wishes. Anyone with a mental disability that rendered them unable to understand the contents of a healthcare document cannot make one that will be valid. People with physical disabilities may make valid healthcare documents by directing another person to sign for them.

Depending on state law, the signing of the document may have to be in the presence of witnesses or a notary public. Typically, if a document is not required to be notarized, it must be witnessed. This additional formality is to ensure that there is at least one other person who can confirm that you were of sound mind and of legal age when you made the document.

A doctor who receives a properly signed and witnessed or notarized directive is under the duty either to honor its instructions, or to make sure the patient is transferred to the care of another doctor who will honor them. To ensure that your wishes will be followed if an unexpected need for your care arises, you should give copies of your documents to your regular physician, your attorney-in-fact, the office of the healthcare facility in which you are likely to receive treatment, and a trusted acquaintance.

The kind of medical procedures that are commonly administered to patients who are seriously ill include: blood, cardio-pulmonary resuscitation (CPR), dialysis, diagnostic tests, drugs, respirators, and surgery. In many states, the laws exclude pain-relieving procedures, food, and water (also called nutrition and hydration) from definitions of life-prolonging treatments that may be withheld because there is some controversy about whether providing food, water, or pain relief will also have the effect of prolonging life. Regardless of state law, under the federal Constitution you are allowed to leave instructions directing that all food, water, and pain relief be withheld.

The directions set out in your written healthcare directive will only be followed if you later become unable to communicate your wishes about the treatment. You can change or revoke your written healthcare wishes at any time in the future. If you find that your document no longer accurately expresses your medical care wishes, you can draw up and finalize a new one to meet your needs.

If you have not completed formal healthcare documents, the doctors who attend you will use their own discretion in deciding what kind of medical care you will receive. If there is a question about whether surgery or some other serious procedure is authorized, doctors will usually turn for guidance to a close relative. Problems may arise if loved ones disagree about what treatment is proper. Conflicts over medical care may end up in court, where a judge unfamiliar with you will decide the future of your treatment. Such conflicts are preventable if you have the foresight to use a formal document to express your wishes for your healthcare.