When making decisions about your future health care, it’s important to plan ahead. Both an advance directive and a living will are documents that allow you to express your medical wishes and preferences in the event you are unable to make decisions for yourself.
But what’s the difference between these two documents?
To put simply, a living will is a kind of an advance directive, focusing solely on end-of-life wishes, while advance directives cover a wider range of medical wishes, preferences, and decisions.
This article will explore the differences between advance directives and living wills so you can make the most suitable decisions for the needs of your estate plan.
What Is an Advance Directive?
An advance directive is a set of legal documents that addresses your wishes and preferences for health care. In most states, an advance directive includes:
- A medical power of attorney that allows you, the principal, to appoint an agent (or health care proxy) to make medical decisions on your behalf;
- A living will that outlines your end-of-life treatment preferences;
- Optionally, a do not resuscitate (DNR) form or a physician order for life-sustaining treatment (POLST).
Advance directives typically come into effect when physicians determine you are incapacitated and unable to make decisions for yourself, which can result from comas, dementia, or permanent vegetative state, depending on state laws.
These directives can cover a broad scope, allowing you to detail your preferences on treatment decisions like life-sustaining surgeries, respiration, resuscitation, nutrition, and medication.
What Is a Living Will?
As previously mentioned, a living will is a type of advance directive. However, it only outlines your preferences regarding life-sustaining procedures and end-of-life medical treatment.
Unlike advance directives, living wills only take effect when you cannot express your medical care wishes due to a terminal illness or near-death situation. More specifically, living wills specify whether or not you want your life to be prolonged, what measures you want to keep you alive, as well as pain management, organ donation, refusal of medical care, and other medical preferences.
It also allows you to specify any religious beliefs you would like observed that may prohibit life-sustaining procedures.
Key Differences between an Advance Directive and a Living Will
Some advance directives encompass multiple advance care planning options and can overlap with living wills in function. However, there are still some differences between the two documents.
Numbers
While advance directives can allow for the appointment of multiple agents and can exist in numerous forms, you are typically restricted to having one living will. This limitation ensures that there is no contradiction in your near-death wishes, preventing any ambiguities during critical moments.
Having multiple advance directives can be beneficial to address varying medical scenarios and to designate different agents for specific situations, offering a more comprehensive and tailored approach to your healthcare preferences.
Scope of Coverage
Advance directives cover a broader scope and are not limited to end-of-life situations. They come into effect upon your incapacitation, address a wide range of health care decisions and allow appointed agents to make the final call on your behalf.
In contrast, living wills are specifically designed for situations where you are near death and unable to communicate their preferences, primarily focusing on treatments, life-sustaining measures, and palliative care options.
Involved Parties
Advance directives generally involve an appointed agent, who is authorized to make health care decisions for you when you are unable to do so.
On the other hand, living wills are primarily directives to healthcare providers, outlining your desired treatments and interventions at the end of life. They serve as a guide to medical personnel, ensuring that your wishes concerning life-sustaining treatment are honored without the necessity for an intermediary.
Personal Preferences
While living wills may often incorporate personal, philosophical, or religious beliefs regarding end-of-life care, advance directives usually focus more on specific medical preferences and the delegation of decision-making authority.
Why Advance Directives and Living Wills Are Important
Without a completed and legally binding living will and advance directive, you and your loved ones may not have control over your medical and end-of-life care if you become incapacitated and unable to make decisions for yourself.
Issues Without an Advance Directive
- Lack of Comprehensive Guidance. Your healthcare team may lack comprehensive instructions on your preferences for various medical situations, not just end-of-life scenarios, resulting in treatments that may not align with your values and wishes.
- Prolonged Disputes. Disagreements among your loved ones regarding medical treatments may occur, and physicians may not know which family member should get the final say. Sometimes, such disagreement may escalate to legal disputes over medical decisions in the absence of an appointed healthcare agent, causing delays and increased stress during critical times.
- Enhanced Emotional Stress. The responsibility of making complex health care decisions may fall on your family members and loved ones who are already dealing with emotional stress, further intensifying their anguish.
States that do not recognize living wills
The states of Massachusetts and Michigan do not recognize living wills. If you reside in one of the two states, make sure you state clearly your wishes and preferences regarding end-of-life treatment in your advance directive.
Issues Without a Living Will
- Emotional Burdens. Your family members may suffer from emotional burdens making life-and-death decisions on your behalf, such as determining how long to have your life prolonged.
- Delayed Medical Decisions. Medical staff may not be able to respond to you quickly in a crisis. Medical treatments that conflict with your beliefs may be used without your consent — resulting in prolonged pain and suffering.
- Financial Strain. Unwanted or prolonged medical treatments can lead to financial burdens on your family due to mounting medical bills.
- Potential for Unwanted Treatments. Without a living will, you might be placed on life support or receive other life-sustaining treatments that you wouldn’t have chosen for yourself.
- Inconsistencies with Religious or Cultural Beliefs. You may receive treatments that are inconsistent with your personal beliefs, cultural values, or religious preferences in the absence of a living will.
Understanding Your Options
Each state has its own unique legislation governing advance directives. People can generally use the forms provided by their state, drafted by an estate planning attorney, or even created independently.
Before you decide to complete your own, you should consult the laws governing the creation, revocation, and validity in the state where you’d like to execute your advance directive.
Completing a living will and advance directive allows you to control your future medical care and reduce suffering for you, your friends, and your family. Start your estate plan with us today.
