What Are Living Wills?

In recent weeks, we've heard end-of-life counseling compared to government run "death boards."

This rhetoric is beyond irresponsible, but it lays bare a very important problem--too many of us have no idea what living wills and other advance directives do, or how they work.

So, a brief primer: In short, these legal documents allow you to tell doctors and hospitals in advance how you wish to be cared for should you be unable to communicate after suffering an illness or accident. If you are in a coma after a car crash, or are unable to speak or write following a stroke, medical professionals can learn your wishes through your living will. A second document, called a health care proxy or medical power of attorney, designates someone--a spouse, adult child, friend, or lawyer, to act as your advocate to be sure the wishes expressed in your living will are carried out.

It isn't any more complicated than that. But claims that these documents are a way to hasten death are simply wrong. A living will can be used to express any wishes for end-of-life care. If you want no extraordinary measures taken to keep you alive, you may use the living will to say so. But if you want absolutely everything possible done, you may use a living will to request that as well. Had Terri Schiavo made a living will that requested that her feeding tube not be withdrawn, that whole awful legal controversy may have been avoided.

The reality of living wills is far from the alleged euthanasia that critics of health reform are claiming. But deliberately or not, their claims do a terrible disservice to those elders who are thinking about advance directives and those adult children who are caring for their parents.