What Is a Living Will?

A living will is a document that outlines how you want your health care managed in the event you’re no longer able to make your own decisions. You can name individuals, or proxies, in the will as agents to make these decisions on your behalf. A living will is also known as an advance health care directive.

Although living wills are usually drafted with end-of-life care and estate planning in mind, they shouldn’t be put off until you’re older. It’s important to prepare for these important decisions at any age.

What’s included in a living will?

In general, a living will should provide directions, called medical directives, for how specific decisions should be handled if you can’t make the decisions for yourself. Common medical directives include:

• Whether or not to be resuscitated via CPR if your heart stops
• Whether or not to be intubated via mechanical breathing if you’re unable to breathe on your own
• Whether or not to be given palliative care, such as pain medication, at the end of your life
• Whether or not to be fed intravenously or via tube feeding, and for how long
• Whether or not to be given antibiotics and antivirals to manage infections at the end of your life
• Which organs and tissues to donate
• Whether or not to donate your body to science after you pass

Your doctor can walk you through each topic and explain your options. It can be a challenging process, so take your time.

Once you’ve made up your mind, you’ll need to document your directives in the form of a living will. Some states have forms you can fill out, while some allow you to create your own. Check what your state requires. Clearly spell out what you want done in each situation so there’s no room for misinterpretation.

Appointing a healthcare proxy

If you appoint a healthcare proxy, they can be named in your living will as a person who to carry out your medical directives. Proxies can be family members, close friends, or an attorney. They may also be referred to by a different name in your state, including:

• Patient advocate
• Health care surrogate
• Health care agent
• Health care attorney-in-fact

It’s very important to discuss your wishes with your potential proxies. Make sure they understand exactly what you want done. Consider talking about their views on dying and end-of-life treatment, religious beliefs, and perspectives on health care.

It’s important that you appoint someone you trust to enforce your medical directives — even if others may disagree with your wishes.

Healthcare proxy vs. power of attorney

Healthcare proxies only have the ability to make medical decisions on your behalf. On the other hand, granting someone power of attorney lets them make financial decisions for you. This may be necessary if your state categorizes managing health insurance and health care bills as financial decisions. If you’d like to grant your proxy power of attorney, an estate lawyer can walk you through the process.

How to get started on a living will

It may be overwhelming to think about what you want to be done medically if you become incapacitated. Here are some steps to take that could help you get started:

1. Speak to your doctor. The more information you have, the better you’ll be able make decisions that are right for you. Ask your doctor about the kinds of health issues that may come up based on your medical records, and the types of decisions your healthcare proxy may face. Talk through the kinds of interventions that will be available, and how you feel about them.²
2. Think about what matters most to you. It may help to think about what you value when you’re deciding on the types of medical treatments you want performed. For instance, is it more important to you that every lifesaving measure is taken if there is the possibility of spending more time with your loved ones? Or would you rather not prolong your life? Leading with your wishes will guide you to the best course of action.²
3. Create your living will.  The specific requirements for a living will vary by state. It’s a good idea to research your local requirements to ensure your living will is in full compliance and is executed accurately.

You might also consider speaking with an estate attorney for guidance as you make your living will or utilizing online digital estate planning tools to create and execute key planning documents.

Understanding the legal framework

Living wills allow you to make clear what your preferences are if you are in a serious medical condition, and you cannot communicate them yourself. Here are answer to some common legal questions regarding living wills:

What are the legal requirements for a living will?

Every state allows you to put in writing your wishes for medical intervention should you become incapacitated, and to name a proxy. Typically, you’ll need two witnesses to sign the document, and they cannot be someone who stands to get an inheritance from you, are related to you, or is your spouse. If you use a lawyer, they may recommend having the living will notarized as well.³

How do living wills vary by state?

Some states have forms you can fill out, while some allow you to create your own. Check what your state requires. If you spend a substantial amount of time in a state other than your home state, you may want to create a living will in that state as well.³

Can a living will be changed or revoked?

Yes, they can. You can simply destroy the existing living will and create a new one.³

Advanced directives and living wills

A living will is an advanced directive, and is a crucial part of planning for the unexpected. But there are other advance directives that you may want to consider creating separately, such as:⁴

• Do-not-resuscitate order: This document, also referred to as a DNR order, stipulates that you do not want measures such as CPR or life-support if your heart and breathing stop. Even if you have this information in your living will, it’s helpful to have a DNR as part for your medical records so your doctor or a hospital has access to it easily.
• Do-not-intubate order: A DNI informs medical staff not to put you on a ventilator if your heart or beathing stops.
• Physician order for life-sustaining treatment and medical orders for life-sustaining treatment: A POLST or MOLST form cover various types of medical decisions you typically make when you are critically ill or near the end of your life. Check with your state to see if they are available.

Myths about living wills

There are some common misconceptions about living wills; here’s the truth:¹

Myth #1: Only a living will can stop medical treatment if you are near the end of life.

The truth: Even without a living will, your doctors will seek input from your family, or health care agent if you have one, before deciding on the best course to take.

Myth #2: Advance directives like living wills means do not treat the patient no matter what.

The truth: A doctor can override a living will if the instructions are not appropriate for the medical emergency or if they do it out of conscience. You can be transferred to a different doctor who will follow your will.

Myth #3: Having a living will simply means I do not want treatment.

The truth: Your living will stipulates the kinds of medical interventions you want in an emergency. Know that no matter what is in your living will, you will not be denied palliative care to relieve pain and suffering.

Myth #4: If I name a healthcare proxy, I won’t be able to make my own medical decisions anymore.

The truth: Your living will only comes into effect if you are unable to make medical decisions on your own. 

You have a living will. Now what?

Once you’ve finalized a living will, distribute copies to everyone who needs it. This may include your proxies, doctor, health care provider, attorney, friends, and family members. You may also want to keep a copy in a secure location, such as a safe. That way, a copy will always be available even if others are lost.