living will

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Living Will

A written document that allows a patient to give explicit instructions about medical treatment to be administered when the patient is terminally ill or permanently unconscious; also called an advance directive.

With improvements in modern medicine, the life of persons who are terminally ill or permanently unconscious can be prolonged. For increasing numbers of persons, the decision of whether to prolong life is being made in the form of a written document called a living will. The living will is one type of advance directive that may be used by a person before incapacitation to outline a full range of treatment preferences or, most often, to reject treatment.

A living will extends the principle of consent, whereby patients must agree to any medical intervention before doctors can proceed. It allows the patient to guide health care for the future when she may be too ill to make decisions concerning care. It can be revoked by the patient at any time. For many the living will preserves personal control and eases the decision-making burden of a family.

Forty-two states and the District of Columbia have living-will statutes that make a properly executed living will legally binding. In states that do not have a statute, living wills stand as a clear expression of the patient's wishes. Living-will statutes require that the person be legally competent to execute the will and that the will be witnessed by at least one disinterested person. Once a person who has a valid living will is terminally ill, the attending physician and a second physician must certify in writing that there is no reasonable expectation for improvement in the patient's condition and that death will occur as a result of the incurable disease, illness, or injury.

Upon this certification the doctor is obligated to follow the instructions contained in the living will. This typically means the patient does not want any medical procedures that serve only to prolong but not prevent the dying process. Therefore, if the patient is unable to breathe, the doctor is not required to connect the patient to a respirator. A patient may state in a living will that he does not want a feeding tube if unable to swallow food. Another common directive is to forbid resuscitation if the patient's heart stops beating.

Living wills have been criticized because they are usually limited to the withholding or withdrawing of "life-sustaining" procedures from a patient with a "terminal condition" or "terminal illness," and thus do not accurately reflect the broad legal right to refuse treatment. In addition, by their very nature, living wills reduce the patient's wishes to writing, and thus may be too rigid (or too vague) to adapt to changing interests or anticipate future circumstances.

To overcome these problems, many states have enacted statutes that permit a competent adult to designate a surrogate decision maker (also termed a health care proxy or agent) to make health care decisions for her in the event of incapacitation. The proxy's authority is usually not limited to decisions about life-sustaining treatment. A proxy can supplement a living will.

All fifty states have durable-power-of-attorney statutes that permit an individual (the principal) to designate another person (the attorney in fact) to perform specific tasks during any period of incapacity. Though most of these statutes do not expressly refer to medical care decisions, no court has ruled that they preclude the delegation of medical decision-making authority to the attorney in fact.

Cross-references

Death and Dying; Health Care Law; Organ Donation Law; Patients' Rights; Physicians and Surgeons; Quinlan, In re.

West's Encyclopedia of American Law, edition 2. Copyright 2008 The Gale Group, Inc. All rights reserved.

living will

n. also called "a durable power of attorney," it is a document authorized by statutes in all states, in which a person appoints someone as his/her proxy or representative to make decisions on maintaining extraordinary life-support if the person becomes too ill, is in a coma or is certain to die. In most states the basic language has been developed by medical associations or other experts and may provide various choices as to when such maintenance of life can be terminated. The decision must be made in consultation with the patient's doctor. The living will permits a terminal patient to die in dignity and protects the physician or hospital from liability for withdrawing or limiting life support.

Copyright © 1981-2005 by Gerald N. Hill and Kathleen T. Hill. All Right reserved.

living will

see ADVANCE DIRECTIVE.
Collins Dictionary of Law © W.J. Stewart, 2006
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One document, typically called a living will, spelled out Morrison's preferences for life-sustaining medical treatment, such as ventilators and feeding tubes.
(1) By requiring firms to create living wills, regulators aim to improve the outcomes for the financial system and the economy when they resolve a firm without assistance--so the temptation of a bailout won't be there to start with.
Barton notes that a living will also frees your loved ones from the pressure of having to make critical medical care decisions for you while they are under stress or in emotional turmoil.
The commonly available WV living will is designed to ensure one receives only care aimed at comfort and dignity when there is no longer acceptable quality of life.
The anonymous survey instrument, which was piloted and validated for Spanish health professionals in a previous study (18) consisted of 16 items, each with three possible answers (Yes, No, I don't know), and aimed to evaluate the respondents' knowledge of the most relevant aspects of living wills and attitudes about their use in clinical practice.
The rules for crafting the living wills are 74 pages long, including an explanatory supplement.
The living will hasn't been changed, either verbally or in writing, since it was drawn up.
The Note will chronicle the development of living wills, identify some of the key concerns raised after the proposed rule, and analyze the extent to which the Final Rule addresses these concerns.
To avoid this outcome, legal and industry practitioners argued at die conference that the design of the first generation of credible living wills should include certain core elements, such as access to critical counterparty and collateral information, triggers for activating recovery or resolution plans, and a menu of available actions related to capital, liquidity, and the declining value of assets as the weaknesses of the firm become evident.
"If international banking in the UK is to remain credible, reform must ensure that the taxpayer is better protected from picking up the bill." The committee also acknowledged that the introduction of living wills would transfer some of the risk from taxpayers to the financial sector.
I WAS very interested in the letter by Sara Wooten, Chronicle, March 18, regarding advanced decision or living wills. I wouldD be like to be given the chance to obtain an advanced decision pack but, as with so many things these days, when one does not have a computer with all the rigmarole of the internet, we are overlooked.
Living Wills that merely express individuals' wishes with regard to life-sustaining procedures.