Legal: Do You Need A Living Will?

The much publicized case of Terri Schiavo was exceptional in many ways, but it had one element that should resonate with anyone who has had to deal with a seriously ill relative or companion: Families frequently disagree about what's right for the patient, sometimes turning a loved one's deathbed into a divisive battleground.

In the case of Schiavo, who was in a persistent vegetative state, her husband and parents became embroiled in a legal dispute about whether to withdraw the feeding tube that had been keeping her alive.

Since this case, more people are thinking about what their wishes would be under similar circumstances and looking for ways to create something outlining what they'd like to see happen were they to be incapacitated. Frequently, these decisions are made in difficult circumstances, in hospices or intensive-care units where several medical issues arise, and tough decisions are required. That's why having something in writing can prove invaluable.

But many people don't. A recent study shows that while eight in 10 Canadians believe it's important to start planning for the end of life while they're healthy, less than a third of them have prepared any specific instructions, and only about half have designated a person to make decisions on their behalf if they're incapable, leaving them the burden of making end-of-life decisions.

Most provinces' legislation includes the concept of a healthcare advocate or proxy who is the person named to be your legal representative, understanding and passing this on to healthcare professionals, family members and friends.

The actual document has various names such as living will, advanced healthcare directive or power of attorney for personal care, depending on the province. In Ontario, it's called the Power of Attorney for Personal Care. In British Columbia it's a Representation Agreement, and in Alberta, a Personal Directive. In most jurisdictions, it must be witnessed by two 'disinterested' people.

All these documents have a number of components: Generally, they designate a specific person to make decisions on your behalf, as well as contain your instructions for personal care, including medical treatments and such issues as shelter, hygiene and clothing.

Not that this covers all eventualities. Serious illness and end-of-life decisions take their toll on families. Family members might attack the validity of the living will on the grounds that you lacked the requisite mental capacity to prepare it. They could also attack the mental competence of your designated proxy at the time that he or she is making any decision on your behalf. This might be particularly true of a surviving spouse who may be ill in their own right. Here's how you can potentially avoid some of this upset.

Work with your physician...

In a comprehensive living will your support team will be prompted to consider everything from pain control and its side effects to which measures, if any, you want taken to potentially prolong your life.
A well crafted document can guide your medical advisors without completely limiting their options.
Your doctor can help you decide what these choices mean for you. Once determined, give him or her - as well as appropriate family members - copies of your living will and power of attorney so that they become part of your permanent medical record.

Choose your proxy wisely...
A spouse is more often than not the usual choice here, but a close friend, perhaps someone even a bit younger than you, may be preferable.
Talk about your wishes, but also discuss his or her role when things get tough - and they inevitably will.
Will this person be able to make difficult decisions?
Can they explain those decisions to family and friends?
Can they deal with the inevitable emotional fallout? What happens if they predecease you?

Keep several copies...

Like all important documents, a living will can't be tucked away in the attic where it won't be found until years after your death.
Your family should know where to find it. And what if you move?
Check that the final document crafted in another province will still carry the weight you wish it to.

Keep the door open...

Review your directives regularly, since your thinking, as well as your family's, may change.
Ask yourself: Are you going to feel the same way about these issues 10 years down the road?

Study a template...

The University of Toronto Centre for Bioethics provides information on living will legislation in each province as well as an example of a detailed living will that can be printed off its Web site.

As always, if we can help, we will.

Article submitted by Velma Carroll, Ten Star Financial Services.
Phone: 905.634.8834
Email
Site

printer friendly

Email this article