Why Not Sign a Living Will Instead of the Will to Live?

Many people who simply do not want what they see as a lot of medical technology prolonging the last few hours or days of their lives when they are terminally ill sign living wills. If you do, in many states you may not know what you’re really signing.

Webster’s Dictionary defines “terminal” as “of or in the final stages of a fatal disease.” And this is what the ordinary person thinks: that somebody who is “terminally ill” is someone who will inevitably die, whose death cannot be prevented by medical treatment.

But in many states, that is not what it means. Instead, for the purposes of the living will you are legally in a “terminal condition” even if your life could be saved–so as to live indefinitely–by medical treatment, so long as you would still have a permanent disability of some kind.

If you sign a legal document you ought to be able to expect that the words in it mean what they are generally understood to mean. If you sign a contract selling your “car” you should not later discover that a legislative act has defined “car” to include “house” and that you’re now homeless. But that is exactly what the laws in many states have done with the wording of their living wills.

Another example: Many people who would not want what they consider the extremes of medical technology would be horrified at the idea of being starved to death. But the laws of most states define the medical treatment that is refused by their living wills to include food and water. While a few states at least have a “check-off” so you can choose whether or not to be starved, in the majority you have no indication in the living will you sign that you are agreeing to starvation.

One widely used “Living Will Declaration,” states, “If I should be in an incurable or irreversible mental or physical condition with no reasonable expectation of recovery, I direct my attending physician to withhold or withdraw treatment that merely prolongs my dying.” This is broad indeed.

If you walk with a limp that can’t be corrected, you have an “irreversible … physical condition.” If you have grown forgetful, with some irretrievable memory loss, you may well have an “incurable … mental condition.” If either of these happens to you, and–having signed the “Living Will Declaration”–you become unable to speak for yourself, that means you will be deprived of all medical treatment and food and water (possibly including what you could be spoon fed) except pain medication and treatment to keep you “comfortable.” Any irreversible disability qualifies as a basis for death.

The term “merely prolongs my dying” may sound as though it limits this, but it really doesn’t. No time frame is given, and the truth is that we are all “dying.” Literally every life-saving medical treatment “prolongs dying,” in the legal sense.

The bottom line is this: if you are someone who doesn’t want medical technology to prolong your last hours, but who also doesn’t want to be starved or allowed to die just because you have a disability, your wishes will be far more likely to be respected if you sign a properly prepared Will to Live than if you sign a living will.