How important is a living will in a COVID-19 emergency? The COVID-19 pandemic has completely changed the world as we know it. This virus has already claimed the lives of over 50,000 Americans, and unfortunately, it doesn’t look like the threat is going away any time soon.
No one ever wants to think about what would happen if we were to become so critically ill that we couldn’t communicate our wishes. However, the possibility of this happening is more real today than ever before. As coronavirus cases continue to mount, doctors, attorneys, and financial advisors are all urging every American to ensure that they have created their essential legal documents, including a living will.
What is a living will, and why is it so important right now? Here’s what you need to know.
What is a Living Will?
First things first – a living will is a legal document that explains your personal choices about the procedures and medications you want (or don’t want) when it comes to end-of-life treatment. This document is often the only way for a person to communicate their wishes, as they may be unconscious or under anesthesia when the time to make the decision arises.
It’s also important to understand what a living will is not. It’s not the same as a medical power of attorney (also known as a healthcare proxy). This is a document gives someone else the power to make medical decisions on your behalf. Many people choose to create both a living will and a healthcare proxy.
What’s Included in a Living Will?
Your living will should include a summary of your wishes when it comes to the most common types of medical treatments. This often includes:
- Cardiopulmonary resuscitation (CPR) – resuscitation if your heart stops beating.
- Mechanical ventilation – intubation if you’re unable to breathe on your own.
- Antibiotics or antiviral medications – aggressive medical treatment of infections.
- Dialysis – treatment for kidney failure
- Tube feeding – nutrition and fluids provided intravenously or through a feeding tube placed in your stomach.
- Comfort (palliative) care – this can cover a wide array of pain management and comfort interventions at the end of life. Some examples include avoiding invasive tests and treatments and being able to die at home.
For each of the items listed above, your living will should indicate whether you want to receive the treatment, and, for treatments like dialysis and tube feeding, how long you wish for it to continue.
Your living will may also address whether you want to be an organ or tissue donor and if you would like to donate your body for scientific study after you die.
When Does a Living Will Go into Effect?
If you have a living will in place, it’s important to make sure that your doctor has a copy so it can become a part of your medical records. If this hasn’t happened, you or someone else can also provide a copy when you arrive at the hospital or at any point up until the decisions have been made.
For a living will to go into effect you must (1) still be alive, (2) be incapacitated or otherwise unable to communicate, and (3) be in terminal condition (unlikely to recover). It’s also important to note that a living will overrides a medical power of attorney (POA). This means that if the person you’ve designated to make medical decisions on your behalf wants something different from what’s written in your living will, their request will be denied.
Why a Living Will is So Important During COVID-19
A living will is an important document that everyone should have in place. Accidents and illnesses happen all the time, and having this document in place gives you extra peace of mind. However, during this COVID-19 crisis, it becomes even more critical. Here are a few reasons why.
The Threat is Very Real
Unfortunately, no one is safe from this virus. There are documented cases in every state in the country, and it can affect people of all ages. Since the virus is often carried by people who don’t have any symptoms, you never know when you could be exposed.
Many people put off creating important documents like this because they’re young and healthy and don’t see a need for it. Others don’t want to think about the possibility that they could become critically ill and possibly die, so they avoid the topic entirely. However, now is the time to face the fact that this threat is very real.
It’s well known that COVID-19 causes life-threatening respiratory conditions and extended hospital stays. If you’re infected, there’s a very good chance that your healthcare providers will need to make some of these important decisions. You’ll want them to know your wishes when they do.
Your Medical Power of Attorney Will Face New Challenges
If you have to go to the hospital for coronavirus treatment, there’s a very good chance that your loved ones won’t get to see you in person again until you’ve either recovered or passed away. Most hospitals are not allowing visitors, which will make it much more difficult for the person you’ve designated in your healthcare proxy to make sound decisions.
Of course, he or she can be reached over the phone and can make decisions based on the information provided by your medical team. However, without being able to see your condition with their own eyes, each decision becomes that much harder. Having a living will on file gives your physicians the proper guidance and can take some stress off of your loved ones.
Important Coronavirus Considerations
If you don’t have a living will and a medical POA, now is the time to get these important documents in place. However, even if you do already have them, you may want to consider having them reviewed in light of a few unique circumstances created by the current coronavirus crisis.
While most healthcare proxies give your medical POA broad authority regarding communication, it’s not a bad idea to add language that explicitly allows medical staff to communicate with your POA over the phone, by email, or through video conferencing. This will help avoid the possibility that problems could arise at a critical moment.
The second issue is much more serious, and it involves the use of a ventilator. Many patients with severe cases of COVID-19 end up needing to be intubated. This allows a ventilator to provide your body with oxygen when you’re unable to breathe.
While your living will may state that you do not wish to be intubated, technically this should only go into effect if you’re considered terminal, that is, if the doctors believe there is very little chance that you’ll recover.
In the case of COVID-19, there’s a possibility that you could go on a ventilator temporarily and then make a recovery. This means that the physicians are now faced with making decisions, hour-by-hour, regarding whether a patient who needs to be intubated actually has a chance of recovering. If the chances are slim, this is considered an invasive procedure and would often fall under the terms of the living will.
On the other side, there’s the concern that you may not receive a ventilator when, in fact, you would have wanted one. This is particularly concerning in light of conversations about ventilator shortages and speculation that rationing could even come into play. It seems that this concern has passed in the United States at this time, but there’s always a chance it could arise again.
Considering just how critical this issue is – often literally a matter of life or death – it makes sense to add language into your living will to make your wishes clear specifically in the case of a coronavirus diagnosis. This way, you can be 100 percent sure that your legal document reflects your true intent.
In addition to ensuring that you’ve created or updated your living will and provided a copy to your physician, it’s also a good idea to talk to your loved ones about your wishes. Although this is an uncomfortable conversation to have, it’s extremely important, especially now.
Create (or Review) Your Living Will Today!
If you don’t have a living will yet, now is the time to do it. It’s possible to create this document yourself using a form provided by your physician or local hospital or online legal document creation software.
If you choose any of these routes, however, you need to make sure you understand your state’s specific requirements. Some require a witness and/or notary, which could present a challenge during times of social distancing. In this case, however, it’s still better to have a document drawn up than to have nothing at all. Due to the extreme importance of this matter, many people choose to have an attorney draw up their documents instead.
We are here to help you should you decide that you need assistance. Contact us today to schedule a consultation.