- What is a Living Will?
A Living Will is a legal document that you can choose to complete if you want. It tells your doctor how to treat you if you cannot make decisions for yourself. A Living Will says that life-prolonging medical interventions that would serve solely to prolong your dying should not be used. A Living Will only applies if you are terminally ill or in a persistent vegetative state AND too sick to make decisions for yourself. Of the forms submitted to the WV e-Directive Registry, 7% are Living Will forms; the Living Will is the 3rd most commonly submitted advance directive.
- What does “terminally ill or in a persistent vegetative state” mean?
A terminal illness is a disease or condition which cannot be cured and is likely to lead to someone’s death. It is also sometimes referred to as a life-limiting illness. If diagnosed correctly, a persistent vegetative state is an irreversible condition in which the person has brain stem function but no higher brain function and is not aware of persons or the outside world. The patient in a persistent vegetative state is unconscious. A persistent vegetative state becomes a permanent vegetative state when the patient has remained unconscious for more than 6 months if there was not a traumatic brain injury causing the condition, or more than 12 months if caused by a traumatic brain injury
- What does “too sick to/cannot make decisions for myself” mean?
The terms about “making decisions for yourself” refers to your mental capacity. Individuals who still have their mental capacity are able to speak for themselves and have an understanding of their medical condition. Individuals who are considered incapacitated are no longer able to speak for themselves based on their inability to understand their medical condition. An individual with advanced dementia or a similar medical condition may be determined to be incapacitated and unable to make decisions.
- What are life-prolonging medical interventions?
Life-prolonging interventions can include (non-exhaustive list):
- cardiopulmonary resuscitation (CPR),
- the use of machines to help with heart, lung, or kidney function,
- the use of feeding tubes or intravenous catheters to deliver food, fluids, blood, and medicines to the body, and
- blood transfusions and antibiotics
It is important that you create an advance care plan that is consistent with your wishes. If you would like any of the above life-prolonging medical interventions to be utilized in your care if you are terminally ill or in a persistent vegetative state and cannot make decisions for yourself, the Living Will is not meant for you. Instead, consider completing a Medical Power of Attorney and documenting your wishes for care—what treatment you would and would not want—in the special directives section of the form.
- What is artificially-provided nutrition and hydration and is it part of life-prolonging medical interventions, which could be withheld in compliance with a Living Will?
Yes. Artificially-provided nutrition and hydration are considered part of life-prolonging medical interventions. Artificially-provided nutrition and hydration is a life-prolonging intervention which allows individuals to still receive food (nutrition) and liquid (fluids) when they can no longer eat or drink as normal. The nutrition and hydration is chemically balanced and can be administered through intravenous (IV) or feeding tube methods. Artificially-provided nutrition and hydration is considered a medical treatment and is inherently different than standard food and liquid consumption and is monitored by a health care provider.
- Can I still have life-prolonging interventions, including artificially-provided nutrition and hydration, if I am NOT terminally ill or in a persistent vegetative state but I can’t make decisions for myself?
Yes. The Living Will does not become effective unless you are terminally ill or in a persistent vegetative state and cannot make decisions for yourself. No medical interventions will be withheld unless you (or if you are unable to make decisions, your Medical Power of Attorney representative/Health Care Surrogate) have specifically requested to not receive a particular intervention(s) regardless of your Living Will until you are in a terminally ill or in a persistent vegetative state. If you are not terminally ill or in a persistent vegetative state but you cannot make decisions for yourself, your authorized Medical Power of Attorney representative (if you completed a Medical Power of Attorney or Combined form) or Health Care Surrogate (if you did not complete a Medical Power of Attorney or Combined form) will be able to speak on your behalf based on your expressed wishes.
- Can I still make my own healthcare decisions once I have completed a Living Will?
Yes. Your Living Will does not take effect until you are terminally ill or in a persistent vegetative state and cannot make decisions for yourself. As long as you can still speak for yourself, you have the right to make your own decisions.
- Can any person create a Living Will?
Yes. Any adult (including a mature or emancipated minor) who has the ability to make decisions can complete a Living Will.
- Do I need a lawyer to create a Living Will?
No. A Living Will can be completed without the help of a lawyer.
- Will another state honor my Living Will?
Laws differ somewhat from state to state, but in general, a patient’s expressed wishes will be honored.
- What should I do with my Living Will after I sign it?
After your form is signed, witnessed, and notarized, keep the original document in a convenient location where it can be easily found. A photo copy of your combined form is legally valid. You are encouraged to send a copy of your Living Will form to the West Virginia e-Directive Registry.