Living Wills and Do Not Resuscitate Orders are both documents relating to end of life care, but they are not one and the same.
During the ongoing pandemic, planning for the future has become increasingly important. As part of that planning, some have found their minds turning to end of life care and putting in place a Living Will (also known as an Advance Directive).
Living Wills are legal statements setting out the circumstances in which the granter would not wish to be kept alive by artificial means. The document allows the granter, whilst of sound mind, to firmly articulate their preferences in terms of medical treatment to be enacted in the event that they are not able to communicate their wishes.
Living Wills are sometimes confused with Do Not Resuscitate Orders or Decisions (DNRs); Living Wills are legal documents, whereas DNRs are medical documents. The former are intended to inform the decisions made by family and medical staff. The latter can be implemented by the medical profession, and there has been recent press coverage regarding DNRs and COVID-19, much of it stark. At least one GP surgery south of the border apparently issued letters (now withdrawn) to vulnerable patients asking them to compete DNR forms.
Living Wills and DNRs are different but there should be coherence and correlation where both are in place.
The content of a Living Will should be carefully considered. There is no set format, however the document usually narrates specified circumstances in which the granter (in the opinion of, for example, two independent physicians) is unlikely to recover and would not wish to be kept alive by artificial means. The Living Will might also contain a statement to the effect that the granter fears indignity more than death. Copies of the Living Will should be made available to the granter’s welfare attorney(s) and GP in order that the granter’s wishes are well known.
Living Wills are not legally binding in Scotland (at variance from the position in England & Wales) but are understood to be taken into account in medical practice. The document is a clear statement of the granter’s wishes, prepared after consideration and under legal direction. It affords the granter an element of choice in relation to their medical treatment and provides crucial guidance to the medical profession and the family, to whom they may defer.
The fundamental importance of the document to the client is in having their voice heard. With that in mind, there is a corresponding importance in having Living Wills renewed from time-to-time; ensuring that family and attending medics can be assured that it represents current wishes.