Released: November 28, 2006

Living will should spell out specifics

Source: Jane E. Brody, New York Times (Free Registration)

When I ask people whether and how they have made preparations for the ends of their lives, the most frequent response is, “Well, I have a living will.” But chances are they are unaware of the serious limitations inherent in such a document and how it is likely to be interpreted by medical personnel should a life-threatening crisis arise.

A living will is an advance directive, a document that states your wishes about how you should be cared for at the end of your life. It is meant to be activated when you are unable to say what you do or do not want to be done medically — if, for example, you are in a terminal condition, your heart and breathing cease, you are in a persistent vegetative state because of severe brain damage or you are too demented to understand the situation.

A living will lists your general preferences for or against life-prolonging treatment like cardiopulmonary resuscitation if your heart suddenly stops, or mechanical respiration if you cannot breathe well enough on your own. But the simple statements contained in most living wills, more often than not, are hard to apply to the great variety of medical situations that can arise.

For example, let’s say you’re a 70-year-old active retiree with congestive heart failure who develops pneumonia and has trouble breathing.

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