What you need to know…

Living wills - sometimes called 'health care directives'- are for adults of all ages, not just the elderly. Some of the most famous court cases about the right to die have involved those in their 20s.

There are good reasons to write down your wishes about end-of-life medical care:

• You might be too sick to express yourself when the time comes
• Your family might disagree about what to do, which leaves doctors in a tough spot and more likely to keep you on life support
• You can help your family with the really tough decision of whether or not to take you off life support
• Living wills often include legal protection for doctors and hospitals, so they don't get sued for honoring your request

Different states have different rules for what living wills should cover, but they all allow you to decline aggressive life support if you're close to death, without affecting your right to get pain medicine or other 'comfort care.' Nor is refusing medical treatment considered suicide; it's not illegal or immoral to let nature take its course.

You can also express your views by writing them down. And talk with your family and doctor to give them an idea of what type of medical condition you would not want continuing treatment for. Is it not being able to talk with your family, or to recognize people and express your thoughts in some way? You might learn that your doctor isn't willing to follow your wishes. If so, find a new doctor.

Drafting a Living Will
A local lawyer can fill you in on the legal requirements for a living will in your state. Most state forms require one or two witnesses to your signature. In some states, your signature as well as those of witnesses must be notarized. Some states restrict who may be a valid witness, typically excluding relatives and your doctor.

Once it's signed, give a copy of your living will to:
• Your regular physician
• Family members
• Consider giving a copy to your minister or a member of your religious community, and to close friends as well
• The hospital you're likely to use. You can mail it to their medical records department, with a cover letter that gives your date of birth and your Social Security number. Verify that they have received the document and have a record of it.
• If you're in a nursing home or are seeing a medical specialist for a serious illness, they ought to get a copy, too

Finally, you can put a card in your wallet saying that you have a living will and whom to call to get a copy. If you're going into a hospital, bring a copy with you. Even if you sent one to the medical records department, it might take a while for the doctors to learn it's there.

Maintaining a Living Will
There's no need to update a living will. However, it's a good idea to check in a few years to see if your state's form has changed. It might be improved later, so you would want to take advantage of these changes. Also, by signing a new one, it shows you haven't changed your mind.

All states' laws allow people to revoke or cancel their living wills. Generally, you should tell your doctor and your family when you revoke or cancel a living will they already know about or have a copy of. If possible, send them something in writing.

No amount of planning can cover all the problems that crop up when we get sick. But it sure can help you and your family when heart-breaking decisions need to be made.