In 2005, the attention of the nation became fixed on a 41-year-old woman named Terri Schaivo. Schaivo’s husband had struggled for nearly decade to get her taken off of a feeding tube after she had spent the previous 15 years in a vegetative state, but her parents disagreed with that decision. The seven-year legal battle that ensued was heart wrenching for everyone involved. Although the Schaivo case was highly publicized, it’s far from a unique situation. Without a living will, you and your family may be vulnerable to being placed in the same impossible situation as Terri Schaivo. Yet according to the American Psychological Association, only 25% of Americans have a living will.
What Does a Living Will Do?
Unlike a conventional will, which outlines your dying wishes for your property after you pass away, a living will is a legal document that explains your living wishes. There are a variety of reasons you might need your living wishes written down. There may come a time when you become incapacitated and can no longer speak for yourself. For example, persons with severe dementia, or someone in a coma, may be alive but unable to enter a legal contract. In the absence of a living will, your loved ones will have to make very difficult decisions about your fate and your best interests, all without your input. Having a living will can prevent you from placing that great burden on your loved ones. In essence, a living will gives you control over your own fate, allowing you to specify what kind of treatments you would want to receive, and gives you control over all your options for end-of-life care.
Precautions to Take
There are several important precautions to take before embarking on the creation of a living will. Like with many medical situations, the most dangerous aspect of a living will is that, occasionally, patients may lack informed consent regarding what they’re agreeing to as laid out in the living will. It’s important to understand that medical terms like “terminal condition” or “severely incapacitated” may be interpreted different ways by different physicians, so they must be clearly defined in your own living will. Furthermore, to make a living will that is compliant with your own wishes, it’s crucial that you understand the dangers of several living will options.
One of the most common types of designations in a living will is the Do Not Resuscitate (DNR). This is a legal order to withhold cardiopulmonary resuscitation should your heart stop. However, there are several things you should understand before making a DNR. In a worst-case scenario, a DNR may allow patients to die when a full recovery could have been made if treatment had been allowed. Furthermore, some hospitals refuse DNR patients from entering their intensive care units, forcing those patients to receive a lower level of care than they normally would. If you decide to have a DNR, you should talk to your doctor in order to investigate policies of hospitals in your area.
Similar to the DNR, Do Not Intubate (DNI) is a designation for patients who don’t want a breathing tube placed in their throat. Most people choose a DNI because they don’t want to spend the rest of their lives on a ventilator. However, be aware that being placed on a ventilator does not mean you will spend the rest of your life attached to it. Many people often use ventilators only for matter of days before the breathing tube is removed and they are able to breathe without assistance. Furthermore, a DNI can often be interpreted to mean that the patient has decided to not be intubated for any reason or for any duration, which can prevent you from receiving life-saving treatment when a full recovery is still possible. Rather than using a DNI, you may want to consider specifying in your living will that you may be taken off these devices should they become a long-term intervention.
The chemical code designation specifies that a patient only wants to be treated with specific medications. In many healthcare facilities, this code means that many common procedures are excluded, including CPR and other lifesaving therapies. Unfortunately, this prevents a wide variety of treatments from being given to a patient, such as the numerous medications that can only be given intravenously with the use of a vein and a needle. In short, the chemical code can seriously restrict your care options.
A Responsible Living Will
It can be a common mistake to believe you don’t need a living will until you’re on your deathbed. Cases like that of the youthful Terri Schaivo show that immeasurable amounts of suffering can be avoided with little more than some forward thinking. Of course, like with any legal document, you should never sign something you don’t understand, and you should always take the time to speak to professionals to understand the details of your arrangement. If you put forth the necessary effort to have a living will that suits your own intentions, it can offer you and your family peace of mind, and ensure you’re all protected against some of the worst possible outcomes.