Advanced Directive / Living Will

Advanced directive

Life is valuable and precious. We all deserve to be treated with the best medical care available. But medical care has its limits. Sometimes there is a point when nothing else can be done to cure a deadly illness or injury. 

Confronted with dying, I would prefer to have aggressive medical treatments stopped so that I can be with my family to die with dignity, quietly and without pain.

ANSWERS TO YOUR QUESTIONS 
ABOUT LIVING WILLS……


When should I sign a Living Will?

Now. The best time to think about your Living Will and talk about it with your doctor and your family is before you have a life-threatening illness or injury. Spend some time thinking about what is important to you. Talk with your doctor, friends and family about your wishes. Ask questions. Then, when you are sure about what you would want, sign your Living Will.

What is a “terminal condition?”

A “terminal condition” is any disease, illness, injury, or condition where there is no reasonable medical expectation of recovery. It will result in death whether life-sustaining treatments or equipment are used or not. Common examples of a terminal condition include severe heart failure or final stages of cancer.

What should I do with my Living Will?

Give copies of your Living Will to your family members, your doctors, and anyone else you feel can help make your wishes known when you can’t. MOST IMPORTANTLY, TALK ABOUT IT. Discuss your Living Will with them so they know exactly what you want. If your doctor does not want to follow your Living Will, he/she is obligated to find you another doctor. Keep a copy of your Living Will with your important papers, but don’t put it in a bank lock box. A card is included to let people know you have a Living Will and to let them know where they can find it.

How can I cancel or change my Living Will?

You may cancel or change your Living Will at any time—orally or in writing.

Are there any other documents I should consider?

You can also have a Durable Power of Attorney for Health Care. It gives a specific person the responsibility to make decisions for you when you are too sick to speak; including making sure your Living Will is followed by your family and your doctor. You need to make sure that person agrees with your desires and is strong enough to carry them out. If you want to have a Durable Power of Attorney for Health Care, call the Tennessee Commission on Aging at (615) 741-2056 for more directions and a free copy of the Tennessee form.

I still have a lot of questions. Where can I go for help?

If you have a question or would just like to talk to someone about Living Wills, call the Choice in Dying free hotline at 1-800-989-WILL (9455) or look up the Choice in Dying web site at www.choices.com . You can also call Alive Hospice at (615) 327-1085 or Tennessee Donor Services at (615) 327-2247. 

THE LIVING WILL

When your condition is terminal and there is no use in trying any other treatments, you can decide to stop further medical care and accept only care that will make you more comfortable. This means there will be no more tubes or unwanted treatment. A Living Will goes into effect only when you are too sick or injured to speak for yourself and when doctors believe you will die without the use of machines or aggressive treatment. If there is a reasonable chance that you can be restored to health, your Living Will will not apply. 

A Living Will is on the opposite page. It is binding under Tennessee law. Yet you can cancel it or change it at any time. 

Additionally, there are two options in the Living Will to consider:

• Do you want food and water to be given through tubes? If not, you can say so. You will still be offered food and water by mouth if you are physically able to take them.
• Do you want to donate your organs/tissues for transplantation after you die? You can say so on the opposite page.

It’s Your Decision

A Living Will gives you control of decisions about your medical care when you have a terminal condition and are unconscious or too sick to communicate. It lets people caring for you know exactly what you want, so that you, and not others, choose how you are treated. It is the best way to make sure your wishes will be respected and maintained by doctors, by other health care providers and by friends and family members.

It’s A Gift

A Living Will is a gift to your family and friends, who otherwise would be left to guess what you want. Families may not have the emotional strength to make those decisions for you. Family members may also disagree among themselves or with your doctors. And when disagreement occurs, the lack of direction often leads to continuation of treatment you may not want. Don’t let this happen to them — or to you! 

Important Notice to Medical Personnel:

I Have a Living Will My primary care physician is: 

________________________________ _________________________________ 
Signature Name 

_________________________________ 
Address 

Please consult this document and/or my family in case of an emergency 

________________________________ __________________________________ 
Name of person to contact Phone 

________________________________ __________________________________ 
Address My Living Will is located at: 

________________________________ __________________________________ 
Phone I am an organ/tissue donor

MY LIVING WILL

I want my family and doctors to know that, if I have a terminal condition and there is no real chance I will recover, no matter what is done, I want aggressive medical treatment stopped. I want to die naturally. Give me only those medicines and treatments that will make me comfortable and pain free. I want cleanliness, privacy and peace in my final hours. Furthermore, 

I want to be offered real food and water that I can eat and drink if I am hungry or thirsty. If I am unable to eat or drink,  I do___/I do not___ want a tube placed in my veins, nose, or throat or surgically placed in my stomach to give me artificial food and fluids. 

I do___/I do not___ want to be an organ/tissue donor after I die. If I am an organ donor, artificial support may be maintained long enough for organs to be removed. 

This Living Will is my own free decision. I accept full responsibility for the consequences of refusing medical care under these circumstances. I know I can change my mind at any time, but, If I don’t, my doctors and family must honor it. 

Date:__________________ Signed_________________________________________ 

Printed name:__________________________________________________________

Witnesses’ Statement:

We believe the adult who signed this Living Will is mentally competent, understands what it means and signed it freely. We are not family, and we won’t benefit financially from his/her death. We are not this person’s doctor or employees of the doctor, hospital, or other health care facility. 

Date:________________ Witness:_________________________________________ 

Witness:______________________________________________________________