Online Will Blog

Creating a Living Will That Truly Reflects Your Personal Values

A living will stands as one of the most personal documents you'll ever create. Far more than a legal formality, it represents your voice when you cannot speak for yourself, ensuring medical decisions honor what matters most to you. While standard forms provide basic frameworks, creating a living will that authentically reflects your unique values requires deeper reflection, clear articulation, and thoughtful customization. This guide explores how to develop a living will that truly embodies your personal healthcare philosophy.

Moving Beyond Standard Forms to Personal Expression

Many people complete living will forms by simply checking boxes without deeper consideration of their implications. Research from the National Institute on Aging suggests that the most effective advance directives go beyond standardized language to include personalized expressions of values and priorities.

A truly personalized living will might address:

• Your definition of an acceptable quality of life
• Specific scenarios of particular concern to you
• How your cultural, religious, or philosophical beliefs inform medical choices
• Personal experiences that have shaped your healthcare preferences
• Your priorities regarding comfort, cognition, independence, and longevity

These personalized elements provide essential context for interpreting your specific medical instructions, helping healthcare providers and loved ones understand not just what treatments you want, but why you want them.

Understanding Your Healthcare Values: Questions for Reflection

Before drafting your living will, take time for deep reflection about what matters most to you. Consider these fundamental questions:

Quality vs. Quantity: How do you balance quality of life against longevity? Would you accept significantly diminished quality for additional time?

Independence and Dependency: What level of dependency on others for basic functions would be acceptable to you? How important is physical self-sufficiency to your sense of dignity?

Comfort vs. Awareness: Would you prefer treatments that keep you more comfortable but perhaps less alert, or maintain maximum awareness even if it means experiencing more discomfort?

Burden Concerns: How do you feel about potentially becoming dependent on loved ones? How should your family balance your care needs against their own wellbeing?

Risk Tolerance: Are you generally willing to try treatments with significant side effects or uncertain outcomes? Or do you prefer more conservative approaches?

The American Bar Association's Commission on Law and Aging offers values assessment tools that can help structure this reflection process, ensuring your living will builds upon a clear understanding of your fundamental healthcare priorities.

Evaheld's values clarification exercises guide you through this essential reflection, helping you identify and articulate what matters most to you in healthcare decisions.

Articulating Your Values in Writing

Once you've reflected on your values, express them clearly in your living will. Consider including a values statement that might address:

Life Priorities: "What has given my life meaning is..."

Acceptable Conditions: "I would find life unacceptable if..."

Religious or Spiritual Beliefs: "My faith guides my healthcare decisions by..."

Previous Experiences: "Based on my experience with [family member's illness], I would want..."

Overall Philosophy: "My general approach to medical care has been..."

This values statement provides crucial context for healthcare providers and representatives who must interpret your specific medical instructions. Studies demonstrate that decisions made with understanding of underlying values more accurately reflect what patients would choose themselves.

Addressing Specific Medical Scenarios with Clarity

While your values statement provides important context, your living will should also address specific medical interventions with clarity. Consider these key areas:

Cardiopulmonary Resuscitation (CPR): Beyond simply accepting or refusing CPR, consider under what conditions you would want resuscitation attempted.

Mechanical Ventilation: Specify not just whether you would accept ventilator support, but for how long and under what circumstances you would want it continued or withdrawn.

Artificial Nutrition and Hydration: Address feeding tubes and IV fluids, considering both short-term and long-term use under different prognoses.

Antibiotics and Other Medications: Clarify your wishes regarding treatments for infections and other conditions, particularly in end-of-life situations.

Dialysis: If your kidneys fail, would you want dialysis, and under what circumstances would you want it discontinued?

Pain Management: Express your priorities regarding pain control, including whether you would accept decreased alertness to achieve better comfort.

Healthcare providers emphasize that specificity about these interventions greatly improves their ability to honor your wishes appropriately.

Creating Scenario-Based Instructions

Rather than making blanket statements about treatments, consider addressing different medical scenarios separately:

Temporary vs. Permanent Conditions: Distinguish between treatments you would accept temporarily with expectation of recovery versus the same treatments in permanent conditions.

Progressive Illness: For conditions like dementia, consider how your preferences might change through different stages of illness.

Sudden Events vs. Chronic Decline: Your preferences might differ for sudden events like stroke versus gradual decline from chronic conditions.

Terminal Illness: Specify particular approaches when death is expected within a defined timeframe regardless of intervention.

Persistent Vegetative State: Address your wishes if you were to become permanently unconscious but not terminally ill.

The National Hospice and Palliative Care Organization provides frameworks for considering these different scenarios, helping you create nuanced instructions that apply appropriately across various circumstances.

Evaheld's living will creation tools help you address these scenarios comprehensively, ensuring your directives respond appropriately to different medical situations.

Guiding Your Healthcare Representative

Your living will works in partnership with your healthcare power of attorney, providing guidance to your designated representative. Strengthen this connection by:

Explaining Your Reasoning: Help your representative understand not just what you want, but why you want it.

Addressing Gray Areas: Provide guidance for situations that fall between scenarios explicitly covered in your directives.

Setting Priorities: If multiple values might conflict, indicate which should take precedence.

Granting Appropriate Flexibility: Consider explicitly giving your representative permission to adjust decisions based on new information or treatments not available when you created your directives.

Research shows that healthcare representatives who receive specific guidance experience significantly less stress when making decisions and feel more confident they're honoring your wishes.

Incorporating Cultural and Spiritual Values

For many people, cultural traditions and spiritual beliefs profoundly influence healthcare preferences. Your living will should address these important dimensions:

Religious Requirements: Document specific religious practices that should be respected during illness or at end-of-life.

Cultural Traditions: Note important cultural approaches to illness, decision-making processes, or care practices.

Spiritual Support: Specify what types of spiritual care or representation you would want during serious illness.

After-Death Practices: While typically addressed in traditional wills, consider including guidance about culturally or religiously significant practices immediately following death.

The team at Evaheld can help you incorporate these deeply personal values into your living will, ensuring healthcare providers understand and respect their importance to you.

Testing Your Living Will for Clarity and Completeness

Before finalizing your living will, test it for effectiveness:

Ask "What If" Questions: Present specific scenarios to your healthcare representative and see if they can determine what you would want based on your directives.

Review with Healthcare Providers: Ask your physician to review your directives and identify any medical terms that might be unclear or scenarios you haven't addressed.

Consider Multiple Perspectives: Have people with different backgrounds read your directives to ensure they're interpretable across cultural or generational differences.

Check for Inconsistencies: Ensure your specific treatment instructions align logically with your stated values.

This testing process often reveals areas needing clarification or expansion, strengthening your living will's effectiveness.

Ensuring Your Living Will Remains Current

Your values and preferences may evolve over time. Healthcare experts recommend reviewing your living will:

• After any major health diagnosis
• When starting a new decade of life
• After significant family changes (marriage, divorce, death of spouse)
• When your designated healthcare representative becomes unavailable
• If your values or preferences regarding end-of-life care change

Regular reviews ensure your living will continues to accurately reflect your current wishes and values.

Conclusion

A living will that truly reflects your personal values stands as one of the most meaningful expressions of your autonomy and identity. By moving beyond standardized forms to thoughtful, personalized directives, you provide healthcare providers and loved ones with clear guidance that authentically represents your unique perspective.

The process of creating such a document often prompts valuable self-reflection and meaningful conversations with loved ones about what matters most during life's most challenging moments. These reflections and conversations, when documented appropriately, provide invaluable guidance during medical crises.

Remember that your living will should evolve as you do, reflecting changes in your health, relationships, and values over time. With support from platforms like Evaheld, you can create and maintain a living will that truly speaks for you when you cannot speak for yourself—honoring not just your medical choices, but the values and beliefs that make you who you are.