I have received some emails from individuals stating that by drafting “Living Wills” for clients, I am assisting them in committing suicide.   The truth of the matter is quite the opposite.  What the document gives an individual is the choice to sustain their life when they are unable to make a decision for themselves because an injury, accident or medical procedure has rendered them medically incompetent to make such a decision.  And yes, the individual may choose not to be kept alive.  This simply means they will expire when whatever life support is keeping them alive is withdrawn and nature will then take over.  It does not mean they are allowing a physician to give them a lethal injection as Dr. Kevorkian used to do.  His method was assisted suicide.  In Virginia (and in the vast majority of the states) assisted suicide is illegal. 

 First let me state that the term “Living Will” is not a legal term.  It is not a will at all.  The document that allows you (“declarant”) to appoint another person (“agent”) to make medical decisions is properly called an Advanced Medical Directive (“AMD”).  Virginia code defines such a document and states you may:
(i) direct a specific procedure or treatment to be provided, such as artificially administered hydration and nutrition;
(ii) direct a specific procedure or treatment to be withheld; or
(iii) appoint an agent to make health care decisions for the declarant as specified in the advance directive if the declarant is determined to be incapable of making an informed decision.  This power includes the decision to make, after the declarant's death, an anatomical gift of all of the deceased’s body or an organ, tissue or eye donation.  And an AMD can be changed or revoked if you change your mind.

 Some of the procedures you can have withheld are no resuscitation—hence the term DNR (do not resuscitate).  You may specify you are not to be placed on a ventilator, or are not to be given surgery, or have certain medications withheld.  The list is as vast as one can imagine, so generally the terms “I have a condition that is incurable or irreversible” and “without the administration of life sustaining treatment, expected to result in death within a relatively short time”, or “I am in a coma or persistent vegetative state which is reasonably concluded to be irreversible” are used to define what your condition has to be before the directive is to be implemented.

 Now the decision process of what you want done must be stated in the AMD. You may decide to that you want to be maintained, no matter the cost.  Or you may decide that the application of life-prolonging procedures would only serve to artificially prolong your dying process and direct that such procedures be withheld or withdrawn.  You may decide to die naturally with only the administration of medication or the performance of any procedure deemed necessary to provide comfort care or to alleviate pain.

 Just about everyone has now heard about Terry Schaivo.  She is the woman in Florida who was in a coma and has numerous medical experts state it is irreversible.  Her husband wanted her life support removed.  Her parents believe otherwise and together with Governor Jeb Bush, through legislation, have tried to keep her alive.  This battle was fought for fourteen years in the courts, the capital, and most recently, through the press.  The message I want you to take out of her situation is not whether letting her die is morally right or wrong or who should “win” the litigation on who has the right to make her medical decisions -- but what would you want done if it was you lying in the bed?  Do you want to be allowed to live or do you want to die?  That decision should be yours to make.

 A recent article in the Virginian-Pilot described the Virginia Beach woman who went in for routine bunion surgery and ended up in a coma and eventually died.  This hits close to home since my wife had the same surgery. This is mentioned because we are all fragile people and can become injured and be near death in so many ways, and age has nothing to do with preventing it.  A thirty year-old male has a one-in-four chance of becoming disabled before age sixty-five. That disability could be a simple injury or a catastrophic one.  Again we do not need to discuss what is right or wrong about a decision to sustain or not.  The question is what do you want? 

 Without the proper documents that state you wishes, you family may be involved in a battle that may rip it asunder.  Also remember that you can appoint another person outside your family to be the agent.  This means a person without a family has an option.  Also, this gives people with a Life Partner an option, since their partner has no legal right in Virginia to decide what happens to their “mate.”  We also register your AMD in a national registry so if something happens to you in another state or country, your Advanced Medical Directive can be accessed by the treating medical facility and your agent contacted.

 You need to an appointment with us so we can fully discuss your wishes and draft you a document that meets your needs. Safeguards that ensure a second competent medical opinion is obtained are should be considered.  Also, our documents are on compliance with HIPAA regulations.  Again, the bottom line is what do you want done?  Circumstances can quickly remove you from the decision process and you need to ensure your wishes are met.