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Feb. 2, 2007
Writing a living will
Leaving exact instructions makes things clear.
SHARON MELNICER
As a competent adult, you have the right to decide to accept or
refuse any medical treatment. "Competent" means you understand
your condition and the results your decision may have. As long as
you are competent, you are the only person who can decide what medical
treatment you want, and do not want, to receive.
Your doctors will give you information and advice about the pros
and cons of different kinds of treatment, but only you can choose
whether to say "yes" or "no." You can say "no"
even if the treatment you refuse might keep you alive longer and
even if your doctor or your family wants you to have it.
Someday, you may become too sick to make your own decisions about
your medical care. If that happens, then decisions will have to
be made for you. If you have not given any instructions, no one
will know what you would have decided. This is where a legal document
known as an "advanced directive" speaks for you.
Advance directives are documents signed by a competent person giving
direction to health-care providers about treatment choices in certain
circumstances. There are two types of advance directives. A durable
power of attorney for health care ("durable power") allows
you to name a "patient advocate" to act for you and carry
out your wishes. A living will allows you to state your wishes in
writing, but does not name a patient advocate. In Canada, we have
the right to name a durable power but, ultimately, it is not legally
binding, despite the fact that it is a common practice in much of
the United States and Europe. But what we Canadians can do is draw
up a living will, the type of advance directive recognized as a
binding legal document across our land.
Why should all Canadians make a living will, even those of us still
in our early 20s? Many people have strong feelings about the kind
of medical care they would like to receive or refuse in certain
circumstances. An advance directive allows you to clearly state
your feelings. There are a few decisions to consider before you
do this, however:
• Who would you like to make treatment decisions for you, if
you become unable to so?
• How do you feel about ventilators, surgery, resuscitation
(CPR), drugs or tube feeding if you were to become terminally ill?
If you were unconscious and not likely to wake up? If you were senile?
• What kind of medical treatment would you want if you had
a severe stroke or other medical condition that made you dependent
on others for all your care?
• What sorts of mental, physical or social abilities are important
for you to enjoy living?
• Do you want to receive every treatment your caregivers recommend?
You can purchase a living will form online or at a stationer's store
like Staples or Office Depot. Of course, your lawyer can also provide
you with the necessary forms. Legal advice is not required but,
if you wish, your attorney can help you prepare a document. You
should talk to the lawyer you have chosen to make sure that the
individual understands your wishes and is willing to act upon them,
as your advocate. It's also wise to discuss your wishes with your
family, friends and health-care team. By law, your family, physicians
and employees of your health-care facility are not allowed to be
witnesses for such a document.
In Canada, you can name a patient advocate, but remember that your
advocate can only have life-sustaining care stopped if you've said
so legally in writing, through a living will. It makes sense to
have written instructions because then everyone can read them and
understand your wishes. A living will states your choices plainly
and clearly. You should make sure your family and caregivers know
what you want in the event that you get sick. It is also important
for hospitals to understand your wishes. Writing them down tells
all concerned, caregivers and family members alike, exactly what
you want.
Finally, it's wise to remember that any decisions you make now about
your future medical treatment can be changed. You can still make
treatment choices as long as you are competent. You can change the
document at any time. It is a good idea to review your living will
each year to be sure it still says how you want to be treated and
names an advocate you trust. If you are no longer competent, but
you have made sure your family and caregivers know what you would
want, it will be easier to follow your wishes. If you have not made
your wishes known to family and caregivers, a court may have to
name a guardian to make decisions for you. Most people want to avoid
that possibility if they can.
Sharon Melnicer is a Winnipeg freelance writer.
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