Writing a Living Will : A Guide on How to Make Advance Medical Decisions

The prospect of future medical issues can be daunting, and it can be hard to anticipate what they future might hold.

If there are certain medical treatments or procedures you don’t want to have, you can make a statement to this effect in a legally binding document.

This legal provision can help you and your family prepare for the future and give you peace of mind now. Read our short guide on what a “Living Will” is and how you can create one.

1) Summary in 30 Seconds

  • A Living Will is another term for an Advance Decision.
  • An Advance Decision is a document where you can make decisions to refuse specific kinds of life-sustaining treatment.
  • You should consult with your doctor or other healthcare professional to make sure you are fully informed of what you are refusing, so that your Advance Decision is valid and applicable if the time comes.
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2) What is a Living Will?

An Advance Decision, or “Living Will’, is a legal document whereby you can make a statement of your refusal to accept certain medical procedures or treatments, in the event that you can’t communicate this.

  • For example: due to Dementia or Alzheimer’s, a terminal illness or an accident which leaves you unconscious.

It has nothing to do with your “Last Will and Testament”, the document where you outline your wishes for the distribution of your estate after death. Apart from making clear your wishes regarding medical care you want to refuse, It also makes things easier for family members, who may disagree with one another about what treatment the person would have wanted or what is in your best interests. By outlining your refusals beforehand, family members won’t be put in a position where they have to decide what to do.

 

  • An Advance Decision is only applicable for the refusal of life-sustaining procedures. This relates to end-of-life care decisions such as Do Not Resuscitate orders, ventilation, artificial nutrition and so on.
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3) Advance Decision or Power of Attorney?

Unlike a Health and Welfare L.P.A., your Advance Decision does not appoint an “Attorney” to manage your affairs and make health and care decisions for you.

An L.P.A. is a legal document that nominates one or more persons to make decisions on your behalf when you no longer are able to yourself. The Health and Welfare L.P.A. gives your Attorney(s) authority to make decisions for your medical care and general well-being and lifestyle choices. Within the L.P.A. you can set specific parameters for what care you would want or do not want and what decisions you will allow your Attorney(s) to decide for you.

Depending on your circumstances, you might find it would be prudent to have an Lasting Power of Attorney appointed as well. But proceed with caution – registering a Health and Welfare L.P.A. without clearly stating in it that the Advance Decision takes precedence over it. It can be complicated to get this right, and it is best to seek legal advice from a solicitor to figure out what you need.

Did You Know?

Most people presume that your next-of-kin will automatically be able to make medical decisions for you. This is not true. They can be consulted by doctors on what would be in your best interests, but they don’t have automatic authority to choose or refuse certain treatments or care for you.

4) How to Make Your Advance Decision

To make an Advance Decision, you must be over 18 and have mental capacity.

  1. Discuss it with your doctor. You should discuss your wishes with a healthcare professional so that you are fully informed of what the implications are. As they know your medical history, they can advise you on the risks and benefits of certain decisions. They can also discuss with you what potential treatments might arise and potential medical interventions you might need in the future, which will better inform what you include in your Advance Decision. You can also have your doctor write and sign a statement to confirm they have discussed the matter with you and can attest to your mental capacity at the time of writing it.

2. Talk to your family, carers and others close to you about your decision. It’s important to make medical decisions that are best for you and not influenced by other people’s view of what you should do. But it is good to make them aware of your choices. They may have questions or objections that you will need to answer. They will probably be advocating for you in other matters if you are hospitalised or undergoing treatment, so it would help if they knew beforehand what your Advance Decision states.

3. Have a solicitor draft it for you. There is no specific form for an Advance Decision. It is possible to find templates online which will give you an outline of how it should be structured and what it needs to include. To be valid it must be:

  • A written document.
  • Signed by you.
  • Witnessed.

An Advance Decision, or “Living Will”, is only valid if the treatment you’ve specified to refuse within it is applicable to the treatment proposed at the time when the decision needs to be made. If it is unclearly specified or outdated when the decision time comes, it will be very difficult for a healthcare professional to make a determination. Without a valid Advance Decision, they will decide on your treatment according to what they conclude is in your best interests. It is possible to create this document yourself. However, if you are in any doubt as to whether it will be sufficient if the time comes, consider having a solicitor draft it for you. A well-drafted statement that not only clearly specifies what you are refusing along with all the relevant circumstances in which you would refuse can give you peace of mind.

4. Review it regularly. This document needs to stay up to date in order to be relevant. There are a few ways that you might need to change your Advance Decision…

  • You might get a new diagnosis or condition.
  • As you get older your viewpoint or feelings might change.
  • Changes in medicine or technology might make it irrelevant or outdated.

It would be good to review it at least every 10 years or so. If you need to change something, make sure to locate and destroy all the old copies so as to avoid confusion in the future.

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To Consider

For doctors to recognise it, an Advance Decision must be applicable to the treatment being offered and the circumstances it is offered in. Think carefully about what you don’t want and seek advice from your doctor or healthcare provider on what kind of circumstances this could arise in.

5) Making an Advance Statement

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To Think About

There can be a lot to consider when making an Advance Decision. You would benefit from getting advice from a solicitor who specialises in this area. They can advise you fully and help you draft an Advance Decision that prepares you for the future.

Along with your Advance Decision, you can also create a document called an Advance Statement. In it you can state your wishes and preferences for your healthcare and lifestyle in the event that you no longer have the mental capacity to make these choices for yourself anymore. Unlike an Advance Decision, it is not legally binding. However, it can support your Advance Decision in giving doctors and healthcare providers a good picture of your feelings, beliefs and preferences in regard to your care and wellbeing.

As with your Advance Statement, this document should be clearly written with your wishes stated in an unambiguous and informed manner. It should be clear that you have written or expressed it and no one else.

If for some reason your Advance Decision is not applicable to a medical situation, they can consult your Advance Statement in order to make decisions for your treatment in what they consider would be your “best interests”. If you have strongly held views or beliefs that you want to convey, it would be wise to include a Statement along with your Advance Decision.

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