The old saw warns us that there is nothing certain but death and taxes, yet we may fail to plan for either. We can prepare for taxes through careful record-keeping and allocation of our finances and, with some forethought, we can plan for end-of-life care too.
If you are suffering from a life-threatening illness or you’re hurt in an accident, you may be unable to make critical decisions for yourself, including the type of medical intervention you want to receive and when you want care to cease. Creating an advance directive, known as a living will, can clarify your wishes and help doctors and loved ones as they make decisions about your care.
Unlike a conventional will, a living will does not provide for disposition of your property. Instead, a living will explain how you want to be treated if you can no longer articulate your wishes. A living will can specify whether you want to be resuscitated if your heart has stopped beating, whether you want to be placed on a ventilator if you can no longer breathe on your own, whether you want to be intubated if you cannot swallow food without aid, and when you want care to cease. Your living will can also outline the types of pain management you want, and when you want to transition from the type of medical care that prolongs your life to the type that upholds quality of life. You may also designate someone you trust as your “health care proxy” or “power of attorney” to make medical decisions for you and ensure that your wishes are carried out.
To adequately spell out your wishes regarding your end-of-life medical treatment, you need two legal documents: a “living will,” also known as an advance health care directive, which tells your doctor what kind of care you want to receive if you become incapacitated, and a “health care power of attorney” (or health care proxy), which names a person to make medical decisions on your behalf if you become unable to. (In many instances, the living will and advance health care directive can be combined in one document.) Your health care proxy can ensure that medical professionals follow the terms of your living will and make decisions that may not have been anticipated by the living will, so choose a proxy that knows you well and whose judgment you can trust. You can change the terms of your living will or the identity of your health care proxy at any time, so you are not stuck with any decisions you make. However, thinking ahead can prevent confusion and anxiety at a difficult moment.