What is a living will?

A living will is a set of instructions explaining a person's wishes about medical care intended to preserve life. It is used if a patient becomes extremely ill and is unable to communicate or make decisions. A living will protects the patient's right to accept or refuse medical care. It also removes the burden for making those decisions from family, friends, and doctors.

Many types of medical care should be considered when preparing a living will. These include the use of dialysis machines, ventilators, respirators, and other equipment to keep a patient alive. Other issues are tube feeding, withholding foods and fluids, the use of CPR once the heartbeat or breathing stops, and organ and tissue donation.

It is important to understand that a decision not to receive "aggressive" medical treatment (doing everything possible to preserve life) is not the same as refusing all care. Even if the treatment goal changes from curing the disease to making the patient as comfortable as possible, the patient may still receive antibiotics, food, pain medication, and radiation therapy.

Patients may change their minds and ask to again receive aggressive treatment. Such a decision may raise insurance issues that should be discussed with the patient's health care plan. Also, any such change should be added to the patient's living will.

Once a living will has been drawn up, patients may want to talk about their decisions with the people close to them. Most states require that the document be witnessed. It is a good idea to put the original living will in a safe, accessible place, and give copies to the patient's doctor, hospital, and next of kin. Patients also may want to keep a card in their wallet stating that they have a living will and where it can be found.

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