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WHAT IS A LIVING WILL?

Living Wills are also known as "Advance Directives". They are "a document in which a person, whilst still competent, requests and directs that certain measures . . . should be adopted if and when they become mentally incapable of taking responsibility for their own health care, i.e, by consenting to or refusing treatment".

(Source; "the Living Will; consent to treatment at the end of life" - report by Age Concern and the Centre of Medical Law and Ethics (1988)).
That is: a Living Will affords a person to leave instructions as to their treatment (or non treatment as the case may be) should they later become unable to give those instructions themselves.

THERE ARE 2 TYPES OF DIRECTIVE:-

1. A REQUEST DIRECTIVE. This is where the person concerned specifies the kind of treatment they want to receive.

2. A REFUSAL DIRECTIVE. This is where the maker gives instructions about the kind of treatment they do not want to receive.

HEALTH CARE PROXY

A person can also appoint someone such as a friend or relative to make decisions on their behalf about their treatment/non-treatment should they become unable to express such wishes for whatever reason. This person is called a "Health Care proxy".

ENFORCEABILITY

NOT ALL OF THE ABOVE ARE LEGALLY ENFORCEABLE.

Only the refusal of treatment under a refusal directive is legally enforceable at present but other instructions, it is hoped, will certainly be taken into account by the patient's medical team and are the surest means of having your express wishes taken account of as such instructions will usually be held with your medical records.

IN WHAT CIRCUMSTANCES SHOULD A LIVING WILL BE CONSIDERED?

A Living Will fills the gap left by an unregistered Lasting Power of Attorney for health and welfare.  A Living Will can not deal with how a presons estate is dealt with upon death as an ordinairy Will would be required.

It is an opportunity to make choices about your preferred type of care at the end of your life and provides you with a right to determine when to receive and when to refuse treatment.

It is therefore useful to consider the making of a Living Will where:-

1. You wish to keep control over your choice of care until the end of your life.

2. You wish to give or refuse your consent to life prolonging treatment.

3. You wish to guide the medical team concerned as to your wishes.

4. You wish to protect your personal dignity at the end of your life.

5. You want to conserve funds and do not wish health care costs to become an excessive expense on your family and/or the community.

6. You wish to "forward plan" and provide guidance in the event of your future incapacity.

7. You want to relieve your family, friends and medical team of the burden and responsibility of having to make decisions without any predetermined guidance.

WHAT DOES THE DIRECTIVE EXCLUDE?

1. Anything which is illegal, e.g. an act of Euthanasia.

2. Insistence on a particular treatment which the medical team consider to be "clinically inappropriate" to your needs/best interests.

3. Refusal of "basic care and maintenance", for example, warmth, shelter, and certain pain relief and hygiene measures. This is a matter of public policy to avoid those caring for a patient being put at risk of harm or the spread of infection.

4. Override statute, e.g, the Mental Health Act which authorises the assessment of individuals, their admission to hospital, guardianship and, if necessary, medical treatment or care WITHOUT their consent. E.g, a hospital admission may be necessary in the interests of the individuals health and safety, or to protect others.

FOR FURTHER INFORMATION

If any of the above has been of interest to you or you have already considered making a living will, please feel free to contact Miss Lisa Barber for further advice and guidance. We look forward to hearing from you and trust that the above has been useful and informative.