Beyond your assets: Living Wills, Advance Directives
In the previous blogs, we explored the importance of making a Will, drafting it clearly, and the painful consequences (for your loved ones) of you dying without one. But there’s another equally important aspect of planning for the future—your own medical choices during your lifetime.
This page is the 5th one of a 6 part blog, the previous page is titled "Without a Will- Burdens on your loved ones after you pass"
What Is a Living Will (Advance Medical Directive)?
A Living Will, also called an Advance Medical Directive, is a legal document that specifies the kind of medical care you want—or don’t want—if you become unable to communicate your wishes.
This would include decisions about:
- Use of ventilators or feeding tubes in terminal illness.
- Whether you want life-prolonging treatment when recovery chances are negligible.
- Whether doctors should perform resuscitation (CPR) or revival by defibrillation etc in critical cases.
The key idea is simple: your family shouldn’t have to make these painful choices for you without guidance on what your wishes were. If you are very sure that do not want to be kept barely alive for months on end being fed liquids through a tube, or don't want to be kept alive in a coma because aggressive treatment was not stopped in time, this is the space to make it clear to your loved ones. If you have clearly stated in your Will that you do not want aggressive treatment or ventilator or tube feeding etc then your family members will find themselves much less burdened when they have to take the tough decision on your behalf when you are physically unable.
There was a case where the father being very unwell was on heavy medication, and virtually in a coma. It was clear that that his advanced age, it was unlikely he would live much longer even if he did come out of the hospital. When the doctor told the family that the father needed to be put on the ventilator the family could not make a decision since the opinion was exactly half for and half against this step. If this aspect had been specified in the Will, then the family would have had no moral dilemma in refusing permission for putting the ventilator. The father was obviously terminally ill but to refuse a ventilator would be seen almost as a crime in their eyes. Once the patient is on a ventilator he can continue living in that comatose state for a very long time - whether in the hospital or after taking him home. The question to ask is what his quality of life is going to be, and how all this will affect the family all the time he remains barely alive on a ventilator. It might sound very cruel to read this bit, but one needs to be pragmatic and take the appropriate decisions in time. Remember that once the ventilator has been started, then you cannot take it off.
All these wishes, directives etc need to be discussed with your family, in times of good health, and with a very firm mind.
In the Living Will section, you can also specify about organ donation or body donation in your Will.
Why It Matters
Modern medicine can sometimes prolong life at the cost of comfort and dignity. A Living Will ensures your preferences are respected and relieves your loved ones of guilt or conflict when making medical decisions. This way none of your family members will hesitate in telling the treating doctor not to undertake aggressive treatment and unnecessarily extend your life at a critical point. The doctor will also have to respect the Will if it is shown to him. After all, your quality of life is also important to you, right?
Although a Living Will can be a separate document, there is no harm if you include it in your main Will. After all, it is your Will and you can write whatever you think is right for you - and it has to be followed. I have included this point in the template for a Will (link is at the bottom).
I recently signed a Do Not Resuscitate (DNR) form during my hospital admission, clearly stating that I didn’t want aggressive life-extending treatment in case of complications during surgery. This made my family’s role much easier—they simply had to follow my wishes.
Legal Recognition in India
- In 2018, India's Supreme Court allowed people to draw up living wills and thereby choose passive euthanasia, where medical treatment can be withdrawn under strict guidelines to hasten a person's death. Active euthanasia is any act that intentionally helps a person kill themselves and is illegal in the country. Here is a link to a blog about the SC Judgement from 2018 about a Living Will. Dr Nikhil Datar, a Malad-based gynaecologist had filed this case. He also fought for and won many rights for pregnant women.
- BBC brought out an article on the importance of a Living Will, the link is here.
- A hospital in Mumbai has started a clinic to help prepare a living Will - here is the link.
Document File for Will Template Click here for a link to the Will Template
This page is the 5th in a 6 part series of posts. The complete indexed list of links is below.
Make your Will now – Part 1 of 6
Key terms in Making a Will- Nominations Beneficiaries Part 2 of 6
Drafting a Will - Guidelines and tips Part 3 of 6
Without a Will - Burdens on your loved ones after you pass -Part 4 of 6
Living Will or Advanced Medical Directives - Post 5 of 6
Some examples, discussions and clarifications - Post 6 of 6 (to be published)
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