Under the most ideal of circumstances, discussions about end-of-life care decisions are difficult, uncomfortable and often thought of as a talk better suited for a later time. But as unsettling as it is, if now is not the time to have a plan in place about your health care wishes, then when is?
No one ever wants to think about the possibility of being incapacitated or in a terminal state. But if that were to happen, would your loved ones know what your wishes are? Would they know where you stand on being kept alive artificially?
Having your health care and end-of-life wishes documented and in place are important for not only your peace of mind but also for your loved ones who may be tasked with seeing your wishes are met.
But differentiating between the various advanced directive documents can be confusing!
Let’s look at two specific types of medical advanced directives – the DNR Order and the Living Will.
A Do Not Resuscitate Order (DNR) is just what it says: a medical order (written by a physician) that states your wishes not to receive cardiopulmonary resuscitation (CPR) if you have stopped breathing or if your heart has stopped. CPR includes cardiac compression, intubation, artificial ventilation, defibrillation, and other related procedures. A DNR order does not have instructions for other treatments, such as pain medicine, other medicines, or nutrition.
You can only put a DNR in place with the assistance of your doctor. Instructions to implement a DNR order are typically given by whoever is legally permitted to make medical decisions on behalf of a patient in the hospital – whether that person is the next of kin or someone you’ve appointed as your healthcare representative (someone you trust to make medical decisions on your behalf.)
Whereas the main job of the DNR is to state that you do not wish to receive CPR, the main job of the living will is to define whether you would or would not like to be kept alive artificially with medical interventions and life support measures (such as artificial nutrition and hydration, dialysis, painkillers, etc.) if in an end-of-life stage condition.
For a living will to go into effect, your doctor must certify that you either have a terminal illness or are in a persistent vegetative state and cannot make decisions for yourself.
And unlike a Last Will and Testament which dictates distribution of your assets and wishes after you pass away, a living will is your voice while you are living but unable to express your medical care wishes.
Advanced health care directives are a critical part of your estate plan, in part, because the future is unpredictable. We never know exactly when end-of-life decisions may be upon us. Documents such as the living will give you the opportunity to communicate your health care wishes if at some point in the future you are unable to state your wishes yourself. They also will help provide guidance to your loved ones about making medical decisions on your behalf. Without these documents, family and medical personnel are left to only guess what you really would have wanted.