There are many formats in which advance directives can be conveyed. Some states have specific formats that require you follow a predefined form. In other states they are created by attorneys or in others it can be completely handled by the subject him or herself.
The Living Will is not a permanent document. Anyone creating one may revise it or revoke it at any time. But, once a Living Will is created, it is important that key family members, legal counsel and medical team members be aware of the document and where it can be located. Should any changes in the document be made, all parties need to be kept up to date.
A living will takes effect when the patient is terminally ill or is permanently unconscious. It is only used to speak for you when you are unable to make decisions and choices on your own. It describes the type of medical treatment you want or do not want to receive in various situations. It can describe under what conditions an attempt to prolong life should be started or stopped.
There are several considerations involved:
- Do you want the use of equipment to help keep you alive?
- Do you want to be resuscitated if your breathing or heartbeat stops?
- Do you want fluid by IV or tube feeding if you cannot eat or drink?
- Do you want palliative or “comfort” care such as treatment for pain, nausea, or other situations if you cannot make other decisions?
- Do you want to donate your organs or other body tissues after death?
Choosing not to have aggressive medical treatment is different from refusing all medical care. A patient can still get treatments such as antibiotics, food, pain medicines, or other treatments. The goal of treatment becomes comfort rather than cure.
The terms “healthcare proxy” and “healthcare agent” or “surrogate” are used interchangeably. It is what the person who has the authority to make medical decisions on your behalf is called. Most people name a close friend or family member. Some people turn to a trusted lawyer or member of the clergy. The designated person should know your values and support your predetermined decisions.