Living Will & Advance Healthcare Directive

Living Will & Advance Healthcare Directive: a practical guide

A living will, often called an advance healthcare directive, records a person's wishes about medical care if illness or injury leaves them unable to communicate. It gives others guidance about those wishes when healthcare decisions need to be made.

What it's for

Use it to put treatment preferences in writing before a serious illness or injury makes it hard to speak for yourself. Describe the kinds of care you would want or refuse in situations that matter to you, and explain what quality of life or outcomes matter in making those choices.

People may use a directive alongside a healthcare proxy, which names someone to make or communicate decisions for them. A living will mainly describes the person's wishes; a proxy mainly identifies a decision maker. Some places combine these roles, so check which document or format fits where it will be used.

Rules about required wording, witnesses, notarization, registration, notice periods, and how the document is shared differ between countries and regions. Check local requirements or ask a qualified lawyer, especially if the directive may guide high-stakes decisions or will be used in more than one place.

Who uses it

• Adults who want to record healthcare preferences before an illness or procedure.
• People diagnosed with a serious or progressive condition who want to discuss future care choices.
• People facing a planned medical procedure that may involve temporary inability to communicate.
• Families or caregivers helping a person document their wishes while the person can still express them.
• People who expect to receive care in a different country or region from where they live.

Terms to decide on

When the directive should guide care

Describe the circumstances in which you want your recorded wishes considered, such as being unable to communicate or make decisions. Use language that is clear to people who may not know your medical history.

Treatment preferences

State which treatments you would want, would refuse, or would want considered only in certain circumstances. Be specific where possible, and explain the circumstances that would change your preference.

Life-prolonging care

Consider how you want decisions about treatment intended to keep you alive to be approached if recovery is unlikely or you cannot communicate. Avoid vague phrases unless you explain what they mean to you.

Comfort and symptom relief

Describe your preferences for relief of pain, breathlessness, anxiety, or other distress, including if other treatment is limited. Make clear what comfort and dignity mean to you.

Personal values and goals

Explain the abilities, relationships, beliefs, or outcomes that matter most to you. This context can help others understand your wishes when a situation is not described exactly.

Decision maker and guidance

If your local document format includes an appointed healthcare decision maker, state who that person is and how you want them to use your wishes. If it does not, consider whether a separate healthcare proxy document is needed.

Review and changes

Decide how you will keep the directive current as your health, wishes, or contact details change. If using Additional Terms & Provisions, write any extra guidance in clear, direct language.

Common mistakes

• Using broad phrases such as “no heroic measures” without explaining which treatments or situations you mean.
• Listing treatments without describing the circumstances in which you would want or refuse them.
• Assuming a living will names someone to make decisions. That role may require a separate document or different local format.
• Writing preferences that conflict with each other, such as refusing all treatment while also requesting a treatment that depends on it.
• Failing to discuss the preferences with the people likely to be involved in care, leaving them unsure how to interpret the document.
• Signing a version without checking whether local rules require witnesses, notarization, registration, notice, or particular wording.
• Keeping the only copy somewhere family members and care providers cannot find it when decisions arise.

Before you sign

• Read the entire directive and confirm it describes your own wishes.
• Check that each preference is clear and tied to the circumstances you mean.
• Resolve any inconsistent instructions or unclear phrases.
• Confirm whether the format covers only your wishes or also appoints a decision maker.
• Check local signing and sharing requirements where the directive may be used.
• Discuss your choices with your healthcare decision maker, if you have one, and close family or caregivers.
• Date and sign it as required, and arrange to share accessible copies with the people who may need them.
• Set a reminder to review it when your health or wishes change.