The importance of a will

A will is important so that patients can give instructions about distribution of their money and property when they die.

Patients can name a trusted family member, friend, or professional to handle their personal affairs (also known as an executor).

It is advisable to seek the expert advice of a lawyer in drawing up a will so that the decisions made about taxes, beneficiaries, and asset distribution will be legally binding.

This process can relieve a patient's family and friends of an enormous burden in case of disputes or questions about allocation of the patient's assets.

What is a living will?

A living will is a set of instructions documenting a person's wishes about medical care intended to sustain life.

It is used if a patient becomes terminally ill, incapacitated, or unable to communicate or make decisions.

Everyone has the right to accept or refuse medical care.

A living will protects the patient's rights and removes the burden for making decisions from family, friends, and physicians.

Types of life-sustaining care to consider when drafting a living will:

• the use of life-sustaining equipment (dialysis machines, ventilators, and respirators)
• "do not resuscitate" orders; that is, instructions not to use CPR if breathing or heartbeat stops
• artificial hydration and nutrition (tube feeding)
• withholding of food and fluids
• palliative/comfort care
• organ and tissue donation

Palliative care versus curative care

It is also important to understand that a decision not to receive "aggressive medical treatment" or curative care is not the same as withholding all medical care.

A patient can still receive antibiotics, nutrition, pain medication, radiation therapy, and other interventions when the goal of treatment becomes comfort rather than cure. This is called palliative care, and its primary focus is helping the patient remain as comfortable as possible.

Patients can change their minds and ask to resume more aggressive treatment. If the type of treatment a patient would like to receive changes, however, it is important to be aware that such a decision may raise insurance issues that will need to be explored with the patient's health care plan.

Any changes in the type of treatment a patient wants to receive should be reflected in the patient's living will.

Steps to take after drafting a living will

Patients may want to talk about their decisions with the people who matter most to them, explaining the values underlying their decisions.

It is likely that the document will need to be signed by witnesses. It is advisable to make copies of the document, place the original in a safe, accessible place, and give copies to the patient's doctor, hospital, and next of kin.

Patients may also want to consider keeping a card in their wallet declaring that they have a living will and where it can be found.

Sources:
http://www.cancer.gov
http://www.cancercare.org/