Living Will/Advance Directive:
Controlling Your Future Medical Care
There may be times in your life when you cannot make your own health care choices. An advance Directive/Living Will helps you plan for your care in these situations. Unless you have a written document to speak for you, your family will be faced with some very difficult decisions. If you prepare legal documents called “Advance Directives,” however, your family can be released from this burden. You can make your wishes known in writing, so the burden of making these decisions are lifted from your family and you can rest assured that you will receive the exact care you wanted. You can have a voice in your care when you cannot speak for yourself. You also can choose who may speak for you. That person will be your “Healthcare Power of Attorney.”
Briefly, Advance Directives are legal documents that give you some control over your future medical care. In the United States, the most common Advance Directive is the “Living Will” which includes a “Healthcare Power of Attorney.” Most estate planning attorneys recommend both documents, in order to cover all situations. Making an advance health care directive is important for all of us — not just for people who know that they will be facing end-of-life decisions in the near future. Anyone may lose their ability to make health care choices without warning due to an unexpected illness or accident. As we have seen, this may occur at any time and at any age. Therefore, we at Vaishnavas CARE encourage everyone to talk about dying with those closest to you in your life to make it more likely that you will die as you might have wished and it will make it easier for your loved ones if they know you have had a ‘good death’.
A “Living Will” allows you to tell your health care provider what types of life-prolonging treatments you want or do NOT want when you are no longer able to speak for yourself. Your Living Will discusses such things as whether or not you would want or not want artificial life support, tube feeding, intravenous or other routes of hydration/feedings and/or CPR or other forms of resuscitation.
A living will becomes active only when you are unable to communicate your medical preferences yourself. In other words, as long as you have the capacity to make your own decisions and communicate those decisions, you will be allowed to do so.
Furthermore, a Living Will generally becomes active in only TWO specific circumstances:
(1) If you should become terminally ill, meaning you have a life-limiting illness;
(2) If you enter a permanent vegetative state. For example, if you suffer a heart attack, but do not have any terminal illness and are not permanently unconscious, a Living Will does not have any effect. You would still be resuscitated, even if you had a Living Will indicating that you do not want life prolonging procedures. A Living Will is only used when your ultimate recovery is considered medically hopeless.
If a Living Will is properly drafted and executed, it binds health care providers to its instructions. Find out ahead of time what your doctor’s views are about Advance Directives and speak to him/her about your specific wishes. If there is a disagreement, you may wish to find a new physician ahead of time.
What is a Health Care Power of Attorney?
A “Health Care Power of Attorney” is a part of your Advance Directive. It allows you to appoint a representative (“proxy”) to make health care decisions on your behalf in the event you are unable to do so yourself. Some states call this document a “Health Care Proxy” or “Durable Power of Attorney for Health Care.”
This document gives your Medical Power of Attorney or “proxy” a lot of control. Therefore, you must choose someone you trust very much. Your proxy must understand your desires, your end-of-life wishes, and have your best interests in mind. Your proxy should be well aware of the choices you have articulated in relevant documents, and should support those instructions. You must ask the person’s permission before appointing him or her as a proxy and then he/she must sign the document agreeing to take on this responsibility. In some geographical areas, the signing of this legal document must be done in front of a notary public. In other words, it must be notarized. This is not required in all places, however. Be sure you know the law where you live.
Your proxy may need to argue your case with doctors or family members. Your proxy may even be required to go to court as in the case of other family members contesting the Living Will. Therefore, an assertive and diplomatic individual is preferred.
Whenever possible, name one or more alternate or successor proxies in case your primary proxy is unavailable. Preferably, do not name co-proxies, because it opens up the possibility of disagreement between them. If there is anyone whom you absolutely want to keep out of playing any role in your health-care decisions, you may be able to disqualify that person expressly in your document. If you should decide to choose a second person as your alternate agent that person will step in if the first person you name as a healthcare agent is unable, unwilling, or unavailable to act on your behalf.
Who Should you Choose?
In most areas your Medical Power of Attorney may be an adult over the age of 18 years old and of sound mind. In some places he or she may be allowed to be a minor under the age of 18 years of age if he or she is married, has graduated from high school, and is an “emancipated minor” (legally free from control of parents) but please check with a legal authority before assigning a minor as your Medical Power of Attorney.
In Krishna consciousness, your life is a preparation for one moment – the moment of death. You hope to remember Lord Krishna at that crucial moment, and thereby gain entrance into the spiritual world. It is crucial that you plan ahead for that moment. Your preparation should include preparing Advance Directives for your medical care. It is advised that you appoint a Medical Power of Attorney who understands the process by which Vaishnavas leave this world, and who will do everything in his or her power to make your passing away from this world auspicious.
Ideally, all preparations will be made by whomever you choose. There will be at least one or more devotees present with you peacefully chanting the Hare Krishna mantra to you days prior to your leaving this world (unless you have verbally requested other instructions or have them written in your Advance Directives).
He or she will work cooperatively and respectively with the medical professionals/hospice staff you have had caring for you throughout your illness.
He or she will have great respect for you as a Vaishnava who has prepared for so long and is now about to take your final journey.
He or she will fully understand the seriousness of this event and the importance of your physical, emotional and spiritual care.
He or she will be dutiful when it comes to fulfilling your desires written in your Advance Directives and will do everything within their power to fulfill your instructions so you will have the spiritual departure you deserve.
Why Should I Name a Medical Power of Attorney when a Family Member or Friend can speak for me if I become Incompetent?
It is recommended to name someone instead of relying on a health care representative to speak for you for one important reason: By planning in advance, you increase the chance that the person who speaks for you will make the choices that you have made in your written Advance Directives. In addition, that person will have the legal right to speak on your behalf.
You may consider speaking to your healthcare practitioner. He or she can assist you in better understanding your medical conditions and the choices you may have to make about your medical care. Give your physician a copy of your Advance Directive/Living Will. Discuss with him or her your wishes and make sure he or she understands what it is you want in case of a terminal illness or a permanent state of unconsciousness due to an illness or an accident.
What Should I Think About When I Make My Advance Directive/Living Will?
It is highly recommended that you consider the following:
*How would you like to be cared for if you have an end-stage medical condition or are permanently unconscious.
Please consider the following:
Life-support and other treatment to keep you alive — Would you want to receive highly technical treatments, such as a tube feeling (artificial nutrition and hydration), or other treatments that your doctor or other physicians in the hospital think will delay the time of your death or keep you in a indefinite unconscious state? Some states in the United States have a law that the physician must administer tube feeding to you unless your Advance Directive/Living Will specifically states that you would NOT want it under any circumstances.
Pain control and other relief — Do you want medication and other treatments to relieve your pain or other severe symptoms, even if they will cause you to sleep more and perhaps make you less able to interact with your family and friends?
Would you want CPR performed, blood transfusions, dialysis, intravenous antibiotics, ETC. ?
What if I Change My Mind?
You should read your Advance Directive/Living Will from time to time to make sure it still expresses your wishes. You can change your directives OR revoke (cancel) your directive completely.
Editor’s Note for those who live within the United States:
Each state within the United States requires their own version of a Living Will/Advanced Directives. Please search on Google to print out a Living Will/Advance Directive and Medical Power of Attorney for your particular State
THE LAWS IN EVERY STATE IN THE U.S. AND EVERY COUNTRY VARY CONCERNING ADVANCE DIRECTIVES/LIVING WILLS. IT IS IMPERATIVE THAT YOU CHECK YOUR AREA WHERE YOU RESIDE TO FIND OUT THE LAW THERE. THIS WEBSITE/INFORMATION IS NOT INTENDED TO TAKE THE PLACE OF LEGAL COUNSEL. THANK YOU.