How to Write a Living Will

After Richard Nixon suffered a severe stroke, doctors determined that the former president had suffered irreversible brain damage. On a respirator, his body might have survived for some time in a vegetative state, but he never could have recovered.

Because Nixon had prepared a living will, the doctors followed his wishes and let him die a peaceful and natural death.

The late president was perhaps the most prominent American to have made out and used an advance directive, but many others are doing so as well.

When people think of legal documents they might need as they age, they usually think of documents such as a will. But a standard will is not used to give directions on end-of-life care. A standard will is a document in which you say who should receive the things you own.

Other documents

These are other documents you should consider:

• A living will. This is a written statement that clearly states to your doctor and family what type of life-sustaining treatments you would accept or refuse if you have a terminal condition and are not able to express your wishes.

• A health care power of attorney, also called durable power of attorney for health care, is more flexible than a living will. It allows you to designate a relative or friend to become your agent to make medical decisions for you when you cannot do so. You should discuss the types of treatment(s) you would or would not want in specific situations ahead of time so that your designated person has some guidelines. If there are no relatives or friends you want to represent you, your health care provider may be the next best choice.

Another commonly used document is called either a “standard power of attorney” or a “durable power of attorney.” These give a person you designate the right to handle personal or financial matters for you. A "standard power of attorney " is not useful if you cannot make your own decisions. A "durable power of attorney" is effective even if you become unable to make decisions for yourself.

Talk with your doctor

You and your health care provider should discuss your advance directives. For example, ask your health care provider what you can expect from your illness or condition. Ask about the possible treatments, their effectiveness, and side effects. Tell  your provider your wishes, the name of your decision maker, and the amount of discretion that you want the decision maker to have. It is also important for you to discuss these issues with family members and friends.

These documents make it easier for family members to make health care decisions on a relative’s behalf. They are recognized in most, but not all, states. Because state laws vary, check with your area office on aging, a lawyer, or financial planner. They will have information on wills, trusts, estates, inheritance taxes, insurance, Medicare, and Medicaid.

Following is an example of a form that includes a living will and a power of attorney. Such forms are relatively simple to fill out. If you'd like to learn more about advance directives, inquire at your hospital or visit the National Hospice and Palliative Care Organization's Web site at http://www.caringinfo.org/planningahead.

Living Will Declaration

I, being of sound mind, willfully and voluntarily make this declaration to be followed if I become incompetent. This declaration reflects my firm and settled commitment to refuse life-sustaining treatment under the circumstances indicated below.

I direct my attending physician to withhold or withdraw life-sustaining treatment that serves only to prolong the process of my dying; if I should be in a terminal condition or in a state of permanent unconsciousness.

I direct that treatment be limited to measures to keep me comfortable and to relieve pain, including any pain that might occur by withholding or withdrawing life-sustaining treatment.

In addition, if I am in the condition described above, I feel especially strongly about the following forms of treatment.

I ( ) do ( ) do not want cardiac resuscitation.

I ( ) do ( ) do not want mechanical respiration.

I ( ) do ( ) do not want tube feeding or any other artificial or invasive form of nutrition (food) or hydration (water).

I ( ) do ( ) do not want blood or blood products.

I ( ) do ( ) do not want any form of surgery or invasive diagnostic tests.

I ( ) do ( ) do nor want kidney dialysis.

I ( ) do ( ) do not want antibiotics.

I realize that if I do not specifically indicate my preference regarding any of the forms of treatment listed above, I may receive that form of treatment.

Other instructions

Surrogate decision making:

I ( ) do ( ) do not want to designate another person as my surrogate to make medical treatment decisions for me if I should be incompetent and in a terminal condition or in a state of permanent unconsciousness.

Name:

Address:

Phone:

Name and address of substitute surrogate (if surrogate designated above is unable to serve):

Name:

Address:

Phone:

I made this declaration on the day of (day) (month, year)

Declarant's signature:

Declarant's address:

The declarant, or the person on behalf of and at the direction of the declarant, knowingly and voluntarily signed this writing by signature or mark in my presence.

Witness's signature:

Witness's address:

Witness's signature:

Witness's address:

Other considerations

• Keep in mind that some treatments, such as mechanical respiration or intravenous feeding may be temporary measures to help you recover from a condition, so you may want to make a statement expressing your wishes regarding life-sustaining treatment if such treatment would prolong the process of dying, not help you recover. 

• You can differentiate between life-prolonging measures you don't want and those designed to comfort you or alleviate pain.

• You can specify which types of treatment you do or do not want. Discuss them first with your doctor.

• You can customize your living will by expressing any personal instructions you might have for your care not covered by the form itself.

• You can appoint someone to serve as a health care proxy or surrogate to speak on your behalf if you should become unable to make an informed decision.

• You also might want to appoint a second health care proxy in case the first is unavailable, or unwilling to serve.

• You sign and have your advance directive witnessed according to your state's law. Distribute copies to your physician, health care proxies, and family members.