Myths and Facts About Living Wills
A living will is known by several other names, including advanced directive, healthcare declaration, medical directive, and many more. There is often confusion about what these words mean and why these documents are important, as well as common myths and misconceptions about how they work. We hope to clear up some of this confusion!
Myth 1: A living will is the same as a last will and testament
A last will and testament is a document that designates how possessions and property will be distributed after a person passes away. A living will, on the other hand, is a document that spells out a person’s wishes for medical treatment in the event that they can’t make decisions for themselves or are faced with a terminal illness. A living will asks for a person who can act as the healthcare proxy to be named, which basically means they can make decisions for the ill person. A living will also asks for preferences and wishes around different health scenarios.
Myth 2: Only those who are sick or dying need a living will
Waiting until a person is seriously ill might be too late to have the discussion to determine his or her wishes. Any person over the age of 18 can having a living will, but more importantly, they should discuss their wishes with their loved ones and doctors, even if they don’t take the added step of filling out a document. In the US, just 20-30% of Americans report having an advanced directive, but even for those that have one on file, only 25% of physicians know of their patients’ directive.1 If no one is aware of the living will, there is no guarantee that it will be honored, so making sure to create one in partnership with your doctor and family is extremely important.
Myth 3: A living will means “Do not resuscitate” or “Do not treat”
A living will or advanced directive does not automatically mean “do not treat.” It allows you to consider both what you do or don’t want in different situations. You can request that treatment continues if it can prolong life, or you can specify that a pain-free, comfortable life is preferable to a longer one full of treatment. There are many things to consider, and talking them through with your family and healthcare team can help you decide what’s important to you.
Myth 4: I can’t afford a lawyer, so I can’t have a living will
Many states don’t have a specific form for an advanced directive, nor do they require a lawyer be present. Additionally, your doctors have a legal obligation to respect your wishes that you communicate to them or transfer your care to someone who will, even if you communicate verbally rather than in a document.2 The best way to ensure that your wishes are carried out is to make sure your doctor and your family are all on the same page, but neither a legal form nor a lawyer is always required. Having a conversation is the truly the most important step!
Myth 5: My wishes will not be carried out unless I have a living will
Your healthcare team would always consult your family and try to come to the right decision for you, even in the absence of a living will. However, without having expressed your wishes, there might be family disputes or general dissatisfaction with your care if different members of your family have different goals for your treatment. Discussing your goals with your loved ones and doctor and outlining these goals in a document is the best way to prevent disagreement and ensure your needs are met.
Myth 6: Having a living will means my wishes must be honored
As explained above, if a person creates a living will without discussing it with their doctor or loved ones, it might be overlooked or not found until much later than the person would prefer. Additionally, doctors can refuse to follow the wishes outlined in a living will if they consider the wishes to be medically inappropriate of clash with their moral values and conscience.2 In this case, they do have an obligation to transfer your care to someone who will honor your wishes, but it is better to know sooner rather than later should this be the case. It’s extremely important to discuss your wishes with your doctor and loved ones to be sure that they are aware and agree with your goals.
- Facing Death: Facts & Figures. Frontline | PBS. https://www.pbs.org/wgbh/pages/frontline/facing-death/facts-and-figures/. Accessed November 1, 2018.
- Myths and Facts About Health Care Advance Directives. American Bar Association. https://www.americanbar.org/content/dam/aba/migrated/Commissions/myths_fact_hc_ad.authcheckdam.pdf. Accessed November 1, 2018.