A Living Will, also known as an Advance Decision or Advance Directive, is a document that allows you to make decisions in advance about specific medical treatments you would or would not want if you become unable to communicate those wishes. Living Wills typically come into play if you are in a serious condition, such as unconsciousness or terminal illness, and where you can't express your preferences. For instance, you might want to refuse certain life-sustaining treatments like artificial ventilation, resuscitation, or feeding tubes.
Living Wills are legally binding in England and Wales, provided they meet specific criteria. It gives you control over your healthcare decisions and helps ensure your wishes are respected by healthcare professionals, even if you're unable to express them yourself.
Benefits of a Living Will
Control Over Your Healthcare Decisions: A Living Will allows you to state in advance what treatments you would like to refuse if you become incapable of making or communicating these decisions. This means that even if you're unconscious or incapacitated, your voice can still be heard.
Reduces Stress for Loved Ones: Making healthcare decisions in crisis situations can be overwhelming for family members. A Living Will provides clear instructions, relieving your loved ones of the burden of making difficult decisions on your behalf.
Ensures Wishes Are Respected: A Living Will makes it more likely that your medical wishes will be followed, providing clarity for healthcare providers and your family. It's especially useful if you're at risk of conditions where you may lose mental capacity, like dementia, or if you're planning ahead for a chronic illness.
Avoiding Unwanted Treatments: By outlining your preferences, you can avoid treatments that you wouldn’t want, such as prolonged artificial life support, which might otherwise be administered.
Downsides of a Living Will
Limited Flexibility: One of the biggest limitations of a Living Will is that it only applies to the scenarios and treatments you specify. If an unexpected medical issue arises that you didn't anticipate, the Living Will might not cover it, potentially leading to confusion.
Risk of Outdated Wishes: Medical technology and treatments advance quickly, and what's available or recommended when you make your Living Will may be very different from what’s available when it's needed. A decision that made sense years ago may not align with the best medical advice at the time of treatment.
Healthcare Providers May Override: While a Living Will is legally binding, healthcare providers can sometimes refuse to follow it if they believe the decisions contradict current medical guidelines or if the document is unclear.
Emotional Impact on Family: Even though a Living Will can remove decision-making stress from family members, it can still be emotionally challenging for loved ones to accept some of your healthcare preferences, especially if they wish for more aggressive treatment or if they feel your wishes may not be in your best interest.
Living Will vs. Lasting Power of Attorney (LPA)
It’s important to understand the difference between a Living Will and a Lasting Power of Attorney (LPA) for Health and Welfare. While both documents deal with your healthcare decisions, they serve different purposes and can work together to ensure your wishes are carried out properly.
Living Will: Focuses on specific medical treatments you want to accept or refuse. It’s a direct instruction to healthcare providers about your care preferences.
LPA for Health and Welfare: Allows you to appoint someone (called an attorney) to make healthcare decisions on your behalf if you lose mental capacity. This document offers more flexibility, as the attorney can make decisions in real-time, considering the context and medical advice available at that moment.
How They Work Together:
A Living Will gives specific instructions about the treatments you want or don’t want. It sets out your wishes in advance and acts as a guide for healthcare professionals.
An LPA gives your attorney the legal power to make decisions on your behalf. If you have both a Living Will and an LPA, the attorney must consider the instructions in your Living Will but has the authority to make broader decisions based on real-time information.
Reasons to Have Both a Living Will and an LPA
Comprehensive Planning: A Living Will outlines your treatment preferences in specific circumstances, while an LPA ensures that someone you trust has the authority to make decisions in all other scenarios. Together, they offer comprehensive coverage.
More Flexibility: If your Living Will doesn’t address a particular medical issue, your attorney under the LPA can step in to make decisions that align with your overall wishes.
Peace of Mind: Knowing that your medical care preferences are clearly documented and someone you trust has the authority to make decisions on your behalf can give you peace of mind.
How to Set Up a Living Will and an LPA
Creating both a Living Will and an LPA is relatively straightforward, but it’s important to get legal advice to ensure they are properly drafted and reflect your wishes.
Living Will: You can write a Living Will yourself, but it must be clear and specific. You need to sign it in the presence of witnesses, and it must be valid under the Mental Capacity Act 2005. It’s also advisable to review it regularly and update it if your preferences change.
LPA: An LPA for Health and Welfare must be registered with the Office of the Public Guardian before it can be used. You’ll need to choose your attorney carefully and discuss your wishes with them in detail.
Conclusion
A Living Will can be an invaluable part of your estate planning, ensuring that your healthcare decisions are respected when you’re unable to voice them yourself. However, it’s not a complete solution on its own. By pairing a Living Will with a Lasting Power of Attorney for Health and Welfare, you ensure that your preferences are respected while also providing flexibility in unforeseen circumstances.
If you're considering setting up a Living Will or an LPA, it’s crucial to consult with a legal professional who can guide you through the process and ensure that both documents reflect your wishes and work together effectively. This combination will offer peace of mind to both you and your family, knowing that all aspects of your future care are considered.
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