Six Myths About Living Wills
As you contemplate end of life issues, misinformation can make the topic of living wills and advance directives confusing. Below are six common myths about living wills and advance directives, followed by the actual facts.
Myth #1 You must have a living will to stop treatment near the end of life.
False. Pennsylvania has Act 169 which allows close family members to make health decisions for you, including the choice to refuse futile treatment. What a living will does is minimize conflict if family members who have equal rights under the law have differing views on how those decisions should be made. It designates the people who you want to make the decisions and guides those people how you feel about end of life care. While it does not completely eliminate conflict, it goes a long way in helping carry out your wishes.
Myth #2 You have to use your state’s statutory form for your advance directive to be valid.
False. Most states (including Pennsylvania) do not require a particular form, but they do have witnessing requirements or other special signing formalities that should be followed.
The critical task in advance care planning is to clarify your values, goals, and wishes that you want others to follow if they must make decisions for you, rather than trying to address every possible medical treatment. Workbooks such as The Tool Kit for Health Care Advance Planning from the American Bar Association can help you.
Myth #3 Advance directives are legally binding, so doctors have to follow them.
False. Advance directives are legally recognized documents and doctors must respect your known wishes, but doctors can always refuse to comply with your wishes if they have an objection of conscience or consider your wishes medically inappropriate. Then, they have an obligation to help transfer you to another health care provider who will comply.
Advance directive laws give doctors and others immunity if they follow your valid advance directive. This is the “carrot” the law provides to them. The only reliable strategy is to discuss your values and wishes with your health care providers ahead of time, to make sure they are clear about what you want, are willing to support your wishes, and they document your wishes.
Myth #4 An advance directive means “Do not treat.”
False, sometimes. No one should ever presume it simply means “Do not treat.” An advance directive can express both what you want and what you don’t want. Even if you do not want further curative treatment, you should always be given “palliative care” which is care and treatment to keep you pain free and comfortable by addressing your medical, emotional, social, and spiritual needs. Sometimes it does, however, mean stopping treatment that is considered futile or will simply prolong the dying process.
Myth #5 If I name a health care surrogate, I give up the right to make my own decisions.
False. Naming a health care agent proxy does not take away any of your authority. You always have the right, while you are still capable of expressing your wishes, to make your own decisions and or revoke the directive.
If you do not name a healthcare agent, the likelihood of needing a court-appointed guardian grows greater, especially if there is disagreement regarding your treatment among your family or between family and doctors.
Choosing a health care proxy is an important decision. It should be someone who knows you very well, with whom you have discussed your values, goals, and preferences, and who is capable of handling the decision-making responsibility as your spokesperson and advocate.
Myth #6 If I am living at home and my advance directive says I don’t want to be resuscitated, EMS will not resuscitate me if I go into cardiac arrest.
Usually False. Your advance directive will usually not help in this situation. If someone dials 911, EMS must attempt to resuscitate you and transport you to a hospital, UNLESS you have an out-of-hospital Do-Not-Resuscitate (DNR) Order which can be ordered by your physician in a bracelet or necklace.
About the Author
Named One of the Main Line’s Top Elder Law Attorneys in 2015
by Main Line Today
Robert M. Slutsky has practiced Elder Law since 1992 and was one of the area’s first elder law attorney. Mr. Slutsky advises clients on Medicaid and Asset Protection Planning, Guardianships, Wills, Trusts, Powers of Attorney, Estate Administration, Special Needs Planning and General Estate Planning. He has represented for profit and non-profit elder care providers and the Pennsylvania Department of Aging. Mr. Slutsky has been the solicitor for the Montgomery County Office of Aging and Adult Services, the Area Agency on Aging for Montgomery County, for over 15 years.