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Living Will: Essential Guide for Planning Your Future Healthcare Decisions

Learn what a living will is, why it's important for all adults regardless of family or financial status, and how to create one to ensure your healthcare wishes are respected.

Introduction

A living will is a legal document that allows you to specify your preferences for medical treatment if you become unable to communicate your wishes due to illness or incapacity. Unlike a traditional will that distributes property after death, a living will takes effect while you're still alive but unable to make healthcare decisions. This powerful document ensures your medical care aligns with your personal values and spares your loved ones from making difficult decisions without knowing your wishes. Whether you're married with children, single without dependents, or have significant assets to protect, a living will is a fundamental component of comprehensive healthcare planning that gives you control over your medical treatment when you need it most.

Key Things to Know

  1. 1

    A living will only takes effect when you cannot communicate your own healthcare decisions and typically requires certification from healthcare providers that you are incapacitated.

  2. 2

    Living wills are recognized in all 50 states, but the specific requirements and forms vary by state, so ensure your document complies with your state's laws.

  3. 3

    Without a living will, healthcare decisions may default to state law and medical protocols, which might not align with your personal wishes.

  4. 4

    Simply creating a living will isn't enough—you need to communicate its existence and location to family members and healthcare providers to ensure it's followed when needed.

  5. 5

    Consider combining your living will with a healthcare power of attorney to name someone you trust to interpret your wishes and make decisions in situations not specifically covered in your living will.

  6. 6

    Review and update your living will every 3-5 years or after significant life changes to ensure it continues to reflect your current wishes.

  7. 7

    A living will can be especially important for individuals with specific religious beliefs or personal values about certain medical treatments.

Key Decisions

Single individuals without children

High net worth individuals

Married individuals with children

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LIVING WILL AND ADVANCE HEALTHCARE DIRECTIVE

DECLARATION

I, [FULL LEGAL NAME], residing at [ADDRESS], born on [DATE OF BIRTH], with Social Security Number [SSN] (optional), telephone number [PHONE NUMBER], and email address [EMAIL ADDRESS], being of sound mind and at least eighteen (18) years of age, willfully and voluntarily make this declaration to express my wishes regarding medical treatment and care in the event I am unable to communicate my healthcare decisions directly.

This document shall serve as my Living Will and Advance Healthcare Directive in accordance with the laws of the state of [STATE]. I intend for this document to be legally binding and enforceable, and I ask that my family, physicians, healthcare providers, and all those concerned with my care honor my wishes as expressed herein.

ARTICLE I: HEALTHCARE AGENT DESIGNATION

Section 1.1: Appointment of Healthcare Agent

I hereby appoint the following individual as my primary healthcare agent (also known as my healthcare proxy or attorney-in-fact for healthcare decisions):

Primary Healthcare Agent:

  • Name: [AGENT NAME]
  • Address: [AGENT ADDRESS]
  • Telephone: [AGENT PHONE]
  • Email: [AGENT EMAIL]
  • Relationship to me: [RELATIONSHIP]

Section 1.2: Alternate Healthcare Agents

In the event that my primary healthcare agent is unable, unwilling, or unavailable to act as my healthcare agent, I appoint the following individuals, in the order listed, to serve as my alternate healthcare agents:

First Alternate Healthcare Agent:

  • Name: [FIRST ALTERNATE NAME]
  • Address: [FIRST ALTERNATE ADDRESS]
  • Telephone: [FIRST ALTERNATE PHONE]
  • Email: [FIRST ALTERNATE EMAIL]
  • Relationship to me: [RELATIONSHIP]

Second Alternate Healthcare Agent:

  • Name: [SECOND ALTERNATE NAME]
  • Address: [SECOND ALTERNATE ADDRESS]
  • Telephone: [SECOND ALTERNATE PHONE]
  • Email: [SECOND ALTERNATE EMAIL]
  • Relationship to me: [RELATIONSHIP]

Section 1.3: Powers and Authority of Healthcare Agent

I grant my healthcare agent full power and authority to make healthcare decisions for me if I am unable to make or communicate decisions for myself. This includes, but is not limited to, the power to:

  1. Consent to, refuse, or withdraw any type of medical care, treatment, surgical procedure, diagnostic procedure, medication, and the use of mechanical or other procedures affecting any portion of my body;

  2. Make decisions regarding artificial nutrition and hydration, cardiopulmonary resuscitation, mechanical ventilation, dialysis, blood transfusions, antibiotics, pain management, and all other forms of medical treatment;

  3. Request, receive, review, and have access to any information, verbal or written, regarding my physical or mental health, including but not limited to medical and hospital records, and to consent to the disclosure of this information as necessary;

  4. Employ and discharge healthcare providers including physicians, psychiatrists, dentists, nurses, therapists, and any other persons who may be involved with my healthcare;

  5. Authorize my admission to or discharge from any hospital, nursing home, residential care, assisted living or similar facility or service;

  6. Take any lawful actions necessary to execute the powers granted herein, including the granting of releases of liability to medical providers;

  7. Apply for public benefits, such as Medicare and Medicaid, for me and to appeal any denial or termination of benefits;

  8. Make decisions regarding participation in research protocols related to my medical condition(s); and

  9. Authorize or decline to authorize visitation as my agent deems appropriate, with the exception of the following individuals who shall be allowed to visit me: [NAMES OF INDIVIDUALS WHO MUST BE ALLOWED TO VISIT, IF ANY].

Section 1.4: Limitations on Healthcare Agent's Authority

Notwithstanding the powers granted above, my healthcare agent is subject to the following limitations:

  1. My healthcare agent must act in good faith and in accordance with my best interests, taking into account my personal values and the preferences expressed in this document;

  2. My healthcare agent may not authorize any of the following, unless I have expressly indicated otherwise in this document or in a separate writing: a. Psychosurgery; b. Sterilization; c. Abortion; d. Voluntary admission to any mental health facility; or e. Experimental treatments or procedures not approved by an Institutional Review Board.

  3. [ANY ADDITIONAL LIMITATIONS ON AGENT'S AUTHORITY]

Section 1.5: HIPAA Authorization

I intend for my healthcare agent to be treated as I would be with respect to my rights regarding the use and disclosure of my individually identifiable health information and other medical records. This release authority applies to any information governed by the Health Insurance Portability and Accountability Act of 1996 (HIPAA), 42 U.S.C. 1320d and 45 CFR 160-164, and the regulations promulgated thereunder.

I authorize any physician, healthcare professional, dentist, health plan, hospital, clinic, laboratory, pharmacy, or other covered healthcare provider, any insurance company, and the Medical Information Bureau, Inc., or other healthcare clearinghouse that has provided treatment or services to me, or that has paid for or is seeking payment from me for such services, to give, disclose, and release to my healthcare agent, without restriction, all of my individually identifiable health information and medical records regarding any past, present, or future medical or mental health condition.

This authorization shall supersede any prior agreement that I may have made with my healthcare providers to restrict access to or disclosure of my individually identifiable health information. The individually identifiable health information and other medical records given, disclosed, or released to my healthcare agent may be subject to redisclosure by my healthcare agent and may no longer be protected by HIPAA.

ARTICLE II: LIFE-SUSTAINING TREATMENT PREFERENCES

Section 2.1: General Statement of Preferences

If I am unable to make or communicate decisions regarding my healthcare, and I have a terminal condition or am in a persistent vegetative state, or my physician and another consulting physician have determined that I am in a condition from which there is no reasonable probability of recovery and which is likely to lead to my death within a relatively short time without the application of life-sustaining procedures, I direct that the following preferences be followed with respect to life-sustaining treatment:

Section 2.2: Cardiopulmonary Resuscitation (CPR)

In the event my heart stops beating or I stop breathing, I direct that:

[SELECT ONE OPTION]

  • I DO want cardiopulmonary resuscitation (CPR) attempted in all circumstances.
  • I DO NOT want cardiopulmonary resuscitation (CPR) attempted if my condition is terminal or irreversible and death is imminent.
  • I DO NOT want cardiopulmonary resuscitation (CPR) attempted under any circumstances.
  • I want CPR attempted ONLY in the following circumstances: [SPECIFY CIRCUMSTANCES]

Section 2.3: Mechanical Ventilation

Regarding the use of a mechanical ventilator (breathing machine) to support or replace my breathing function, I direct that:

[SELECT ONE OPTION]

  • I DO want mechanical ventilation used in all circumstances.
  • I DO want a trial period of mechanical ventilation, but if after [SPECIFY TIME PERIOD, e.g., "14 days"] there is no significant improvement in my condition, I direct that mechanical ventilation be withdrawn.
  • I DO NOT want mechanical ventilation if my condition is terminal or irreversible and death is imminent.
  • I DO NOT want mechanical ventilation under any circumstances.
  • I want mechanical ventilation ONLY in the following circumstances: [SPECIFY CIRCUMSTANCES]

Section 2.4: Artificial Nutrition and Hydration

Regarding the provision of nutrition and hydration through artificial means such as feeding tubes or intravenous lines when I am unable to take food or water by mouth, I direct that:

[SELECT ONE OPTION]

  • I DO want artificial nutrition and hydration provided in all circumstances.
  • I DO want a trial period of artificial nutrition and hydration, but if after [SPECIFY TIME PERIOD, e.g., "30 days"] there is no significant improvement in my condition, I direct that artificial nutrition and hydration be withdrawn.
  • I DO NOT want artificial nutrition and hydration if my condition is terminal or irreversible and death is imminent.
  • I DO NOT want artificial nutrition and hydration under any circumstances.
  • I want artificial nutrition and hydration ONLY in the following circumstances: [SPECIFY CIRCUMSTANCES]

Section 2.5: Dialysis

Regarding the use of dialysis to filter waste from my blood if my kidneys stop functioning properly, I direct that:

[SELECT ONE OPTION]

  • I DO want dialysis used in all circumstances.
  • I DO want a trial period of dialysis, but if after [SPECIFY TIME PERIOD, e.g., "30 days"] there is no significant improvement in my condition, I direct that dialysis be discontinued.
  • I DO NOT want dialysis if my condition is terminal or irreversible and death is imminent.
  • I DO NOT want dialysis under any circumstances.
  • I want dialysis ONLY in the following circumstances: [SPECIFY CIRCUMSTANCES]

Section 2.6: Antibiotics and Medication

Regarding the use of antibiotics and other medications to treat infections or manage symptoms, I direct that:

[SELECT ONE OPTION]

  • I DO want antibiotics and other medications administered in all circumstances.
  • I DO want antibiotics and other medications for the purpose of treating infections, but not if my condition is terminal or irreversible and death is imminent.
  • I DO NOT want antibiotics under any circumstances, but I DO want medications for pain relief and comfort care.
  • I want antibiotics and other medications ONLY in the following circumstances: [SPECIFY CIRCUMSTANCES]

Section 2.7: Pain Management and Comfort Care

Regarding pain management and comfort care (palliative care), I direct that:

  1. I wish to receive adequate pain medication to ensure my comfort, even if such medication might hasten my death.

  2. I wish to receive palliative care focused on relieving pain and suffering, managing symptoms, and maximizing quality of life rather than extending it when cure is no longer possible.

  3. I wish to die at [SELECT ONE: "home," "hospice facility," "hospital," or "OTHER LOCATION"] if possible and if it does not place an undue burden on my family or caregivers.

  4. Additional instructions regarding pain management and comfort care: [ADDITIONAL INSTRUCTIONS]

ARTICLE III: SPECIFIC MEDICAL SCENARIOS

Section 3.1: Persistent Vegetative State

If I am diagnosed as being in a persistent vegetative state or permanent unconscious condition with no reasonable hope of recovery, as determined by my attending physician and at least one other qualified physician, I direct that:

  1. Life-sustaining treatment, including artificial nutrition and hydration, be withheld or withdrawn.

  2. I be allowed to die naturally, with only the administration of medication or the performance of any medical procedure deemed necessary to provide me with comfort care or to alleviate pain.

  3. Additional instructions: [ADDITIONAL INSTRUCTIONS]

Section 3.2: Terminal Illness

If I am diagnosed with a terminal illness or condition and death is expected within six months, as determined by my attending physician and at least one other qualified physician, I direct that:

  1. Life-sustaining treatment that would serve only to artificially prolong the process of my dying be withheld or withdrawn.

  2. I be allowed to die naturally, with only the administration of medication or the performance of any medical procedure deemed necessary to provide me with comfort care or to alleviate pain.

  3. Additional instructions: [ADDITIONAL INSTRUCTIONS]

Section 3.3: End-Stage Condition

If I am diagnosed with an end-stage condition that has caused severe and permanent deterioration, indicated by incompetency and complete physical dependency for which treatment of the irreversible condition would be medically ineffective, as determined by my attending physician and at least one other qualified physician, I direct that:

  1. Life-sustaining treatment, including artificial nutrition and hydration, be withheld or withdrawn.

  2. I be allowed to die naturally, with only the administration of medication or the performance of any medical procedure deemed necessary to provide me with comfort care or to alleviate pain.

  3. Additional instructions: [ADDITIONAL INSTRUCTIONS]

Section 3.4: Dementia Provisions

If I am diagnosed with severe dementia or similar cognitive impairment, such that I am unable to recognize my family or loved ones, unable to communicate verbally, and am dependent on others for most or all of my care, I direct that:

  1. No life-sustaining procedures, including artificial nutrition and hydration, be initiated or continued when they would serve only to prolong my existence.

  2. I not be given antibiotics for infections such as pneumonia or other life-threatening infections if the primary purpose is to prolong my life rather than provide comfort.

  3. I be allowed to die naturally, with only the administration of medication or the performance of any medical procedure deemed necessary to provide me with comfort care or to alleviate pain.

  4. If I appear to be experiencing distress or discomfort, I wish to receive appropriate medication to relieve such distress or discomfort, even if such medication might hasten my death.

  5. Additional instructions: [ADDITIONAL INSTRUCTIONS]

ARTICLE IV: ORGAN AND TISSUE DONATION

Section 4.1: Organ Donation Wishes

[SELECT ONE OPTION]

  • I DO wish to be an organ and tissue donor. I authorize the donation of any organs, tissues, or parts of my body for transplantation, therapy, research, or education.
  • I DO wish to be an organ and tissue donor, but ONLY for the following organs or tissues: [SPECIFY ORGANS/TISSUES]
  • I DO wish to be an organ and tissue donor, but with the following restrictions: [SPECIFY RESTRICTIONS]
  • I DO NOT wish to be an organ or tissue donor.

Section 4.2: Body Donation for Medical Research

[SELECT ONE OPTION]

  • I DO wish to donate my body for medical research or educational purposes.
  • I DO wish to donate my body for medical research or educational purposes, but with the following restrictions: [SPECIFY RESTRICTIONS]
  • I DO NOT wish to donate my body for medical research or educational purposes.

If I have elected to donate my body for medical research or educational purposes, I understand that this may preclude organ donation for transplantation purposes. In case of conflict, my preference is: [SELECT ONE: "organ donation for transplantation" or "whole body donation for research/education"].

ARTICLE V: FUNERAL AND BURIAL ARRANGEMENTS

Section 5.1: Funeral Preferences

My preferences regarding funeral services are as follows:

  1. I wish to have a [SELECT ONE: "traditional funeral service," "memorial service," "celebration of life," "no service," or "OTHER PREFERENCE"].

  2. I prefer that the service be held at [LOCATION PREFERENCE].

  3. I would like the following religious or spiritual elements to be included: [RELIGIOUS/SPIRITUAL ELEMENTS].

  4. Other specific requests regarding my funeral service: [SPECIFIC REQUESTS].

Section 5.2: Disposition of Remains

Regarding the disposition of my remains, I direct the following:

[SELECT ONE OPTION]

  • I wish to be buried at [CEMETERY NAME AND LOCATION].
  • I wish to be cremated, and my ashes disposed of as follows: [SPECIFY DISPOSITION OF ASHES].
  • I wish for my body to be donated to medical science as specified in Section 4.2.
  • Other disposition: [SPECIFY OTHER DISPOSITION].

Section 5.3: Memorial Contributions

In lieu of flowers, I request that memorial contributions be made to:

  1. [CHARITY/ORGANIZATION NAME AND ADDRESS]
  2. [CHARITY/ORGANIZATION NAME AND ADDRESS]
  3. [CHARITY/ORGANIZATION NAME AND ADDRESS]

ARTICLE VI: ADDITIONAL CONSIDERATIONS

Section 6.1: Religious or Spiritual Preferences

My religious or spiritual beliefs that should guide my medical care and end-of-life decisions are as follows:

  1. Religious/spiritual affiliation: [RELIGIOUS/SPIRITUAL AFFILIATION]

  2. Religious/spiritual practices that are important to me: [IMPORTANT PRACTICES]

  3. I would like to receive the following religious/spiritual support at the end of life: [RELIGIOUS/SPIRITUAL SUPPORT]

  4. I would like the following religious/spiritual leader to be contacted:

    • Name: [RELIGIOUS/SPIRITUAL LEADER NAME]
    • Organization: [ORGANIZATION NAME]
    • Contact information: [CONTACT INFORMATION]

Section 6.2: Personal Values Statement

The following values and beliefs are important to me and should guide the interpretation of this document and any healthcare decisions made on my behalf:

  1. [PERSONAL VALUE #1]
  2. [PERSONAL VALUE #2]
  3. [PERSONAL VALUE #3]
  4. [ADDITIONAL VALUES AS NEEDED]

When making healthcare decisions on my behalf, I want my healthcare agent and healthcare providers to consider the following quality of life factors that are important to me:

  1. [QUALITY OF LIFE FACTOR #1]
  2. [QUALITY OF LIFE FACTOR #2]
  3. [QUALITY OF LIFE FACTOR #3]
  4. [ADDITIONAL FACTORS AS NEEDED]

Section 6.3: Pregnancy Provisions

[FOR WOMEN OF CHILDBEARING AGE] If I am pregnant at the time this directive becomes effective, I direct that:

[SELECT ONE OPTION]

  • All life-sustaining treatment be provided to me, regardless of my condition, until my child can be safely delivered.
  • Life-sustaining treatment be provided to me only if my physician believes there is a reasonable possibility that my child will develop to the point of live birth with continued application of life-sustaining treatment.
  • The same treatment preferences expressed elsewhere in this document be followed, regardless of my pregnancy status, to the extent permitted by law.
  • The following specific instructions be followed regarding my care if I am pregnant: [SPECIFIC INSTRUCTIONS]

I understand that in some states, a Living Will or similar directive may not be honored during pregnancy regardless of my wishes.

Section 6.4: Digital Assets and Social Media

Regarding my digital assets and social media accounts during my incapacity, I direct that:

  1. My healthcare agent shall have the authority to access, modify, control, archive, transfer, and delete my digital assets, including but not limited to my email accounts, social media accounts, digital music, digital photographs, digital videos, gaming accounts, software licenses, cloud storage accounts, domain registrations, web hosting accounts, cryptocurrency, and other online accounts.

  2. My healthcare agent may post appropriate notifications regarding my condition on my social media accounts and may respond to messages sent to me through these platforms.

  3. I specifically authorize my healthcare agent to take the following actions with respect to my digital assets and social media accounts: [SPECIFIC AUTHORIZATIONS]

  4. I specifically prohibit my healthcare agent from taking the following actions with respect to my digital assets and social media accounts: [SPECIFIC PROHIBITIONS]

  5. Access information for important digital accounts:

    • Password manager: [PASSWORD MANAGER INFORMATION]
    • Important account #1: [ACCOUNT INFORMATION]
    • Important account #2: [ACCOUNT INFORMATION]
    • [ADDITIONAL ACCOUNTS AS NEEDED]

ARTICLE VII: LEGAL PROVISIONS

Section 7.1: Revocation

I understand that I may revoke this Living Will and Advance Healthcare Directive at any time by:

  1. Physically destroying this document or directing someone else to destroy it in my presence;
  2. Signing and dating a written revocation;
  3. Verbally expressing my intent to revoke this document in the presence of a witness who is at least 18 years of age, who understands the nature of the revocation, and who signs and dates a writing confirming my expression to revoke; or
  4. Executing a new Living Will and Advance Healthcare Directive that is materially different from this one.

I understand that if I revoke this document, I should notify my healthcare agent, my healthcare providers, and anyone else who has a copy of this document.

Section 7.2: Severability

If any provision of this Living Will and Advance Healthcare Directive is held to be invalid, illegal, unenforceable, or inapplicable to any circumstance by a court of competent jurisdiction in the state of [STATE], such provision shall be deemed modified to the minimum extent necessary to make it valid, legal, and enforceable while preserving its intent, or if such modification is not possible, such provision shall be severed from this document. The invalidity, illegality, unenforceability, or inapplicability of any provision shall not affect any other provisions or applications of this document, which shall continue in full force and effect without the invalid, illegal, unenforceable, or inapplicable provision.

Section 7.3: Governing Law

This Living Will and Advance Healthcare Directive shall be governed by and construed in accordance with the laws of the state of [STATE], without giving effect to any choice of law or conflict of law provisions.

Section 7.4: Definitions

For purposes of this document, the following terms shall have the meanings set forth below:

  1. "Life-sustaining treatment" means any medical procedure, treatment, intervention, or other measure that, when administered to a patient, will serve to prolong the process of dying or to maintain the patient in a condition of permanent unconsciousness.

  2. "Terminal condition" means an incurable and irreversible condition that, without the administration of life-sustaining treatment, will, in the opinion of the attending physician and at least one other consulting physician, result in death within a relatively short time.

  3. "Persistent vegetative state" means a permanent and irreversible condition of unconsciousness in which there is: (a) the absence of voluntary action or cognitive behavior of any kind, and (b) an inability to communicate or interact purposefully with the environment.

  4. "End-stage condition" means an irreversible condition that is caused by injury, disease, or illness which has resulted in progressively severe and permanent deterioration, and which, to a reasonable degree of medical probability, treatment of the condition would be ineffective.

  5. "Healthcare agent" means an individual designated in a healthcare power of attorney or similar document to make healthcare decisions on behalf of the person executing the document.

  6. "Artificial nutrition and hydration" means the provision of nutrients or fluids by a tube inserted into a vein, under the skin, or in the stomach or intestines.

Section 7.5: Conflicting Provisions

If any provision of this Living Will and Advance Healthcare Directive conflicts with any provision of a Durable Power of Attorney for Healthcare that I have previously executed and not revoked, the provision of the document executed most recently shall control.

ARTICLE VIII: DISTRIBUTION AND ACCESS

Section 8.1: Distribution List

I direct that copies of this Living Will and Advance Healthcare Directive be provided to the following individuals and institutions:

  1. My primary healthcare agent: [PRIMARY AGENT NAME]
  2. My alternate healthcare agents: [ALTERNATE AGENT NAMES]
  3. My primary care physician: [PHYSICIAN NAME AND CONTACT INFORMATION]
  4. My specialist physicians: [SPECIALIST NAMES AND CONTACT INFORMATION]
  5. The hospital(s) where I typically receive care: [HOSPITAL NAMES]
  6. My immediate family members: [FAMILY MEMBER NAMES]
  7. My attorney: [ATTORNEY NAME AND CONTACT INFORMATION]
  8. [OTHER RECIPIENTS AS APPROPRIATE]

Section 8.2: Electronic Access Provisions

Electronic copies of this document are stored in the following locations, and may be accessed as follows:

  1. My personal computer: [LOCATION AND ACCESS INFORMATION]
  2. Cloud storage: [SERVICE NAME AND ACCESS INFORMATION]
  3. Electronic registry: [REGISTRY NAME AND ACCESS INFORMATION]
  4. With my attorney: [ATTORNEY NAME AND CONTACT INFORMATION]
  5. [OTHER ELECTRONIC STORAGE LOCATIONS]

In case of emergency, my healthcare agent or healthcare providers may access electronic copies of this document by contacting the individuals listed above or by using the following emergency access information: [EMERGENCY ACCESS INFORMATION]

ARTICLE IX: INTEGRATION WITH OTHER DOCUMENTS

Section 9.1: Coordination with Other Advance Directives

This Living Will and Advance Healthcare Directive is intended to work in conjunction with the following other advance directives that I have executed:

  1. Durable Power of Attorney for Healthcare, dated [DATE]
  2. POLST (Physician Orders for Life-Sustaining Treatment) or similar form, dated [DATE]
  3. DNR (Do Not Resuscitate) Order, dated [DATE]
  4. [OTHER RELEVANT DOCUMENTS]

In the event of any conflict between this document and any other advance directive I have executed, the document executed most recently shall control, unless otherwise specified herein.

Section 9.2: Consistency with Estate Plan

This Living Will and Advance Healthcare Directive is intended to be consistent with my overall estate plan, including my Last Will and Testament dated [DATE] and any Trust Agreements I have established. My healthcare agent should consult with the executor of my estate and/or the trustee of any trust I have established if questions arise regarding the coordination of my healthcare decisions with my overall estate plan.

EXECUTION

IN WITNESS WHEREOF, I sign this Living Will and Advance Healthcare Directive voluntarily, while of sound mind and under no constraint or undue influence.

Dated: ________________________

Signature: ________________________

Print Name: [FULL LEGAL NAME]

WITNESS ATTESTATION

The declarant is personally known to me and I believe the declarant to be of sound mind and under no constraint or undue influence. I am at least eighteen (18) years of age and am not related to the declarant by blood, marriage, or adoption, and am not entitled to any portion of the declarant's estate under any existing will or codicil or by operation of law. I am not the declarant's attending physician, the healthcare agent, or an employee of the attending physician or healthcare facility in which the declarant is a patient.

Witness #1:

Signature: ________________________

Print Name: ________________________

Address: ________________________

Date: ________________________

Witness #2:

Signature: ________________________

Print Name: ________________________

Address: ________________________

Date: ________________________

NOTARY ACKNOWLEDGMENT

State of ________________________

County of ________________________

On ________________________, before me, ________________________, a Notary Public, personally appeared [FULL LEGAL NAME], who proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to the within instrument and acknowledged to me that he/she executed the same in his/her authorized capacity, and that by his/her signature on the instrument the person executed the instrument.

I certify under PENALTY OF PERJURY under the laws of the State of ________________________ that the foregoing paragraph is true and correct.

WITNESS my hand and official seal.

Signature: ________________________ (Seal)

My commission expires: ________________________

Missouri Requirements for Living Will

Legal Authority for Living Will (Missouri Revised Statutes § 459.010-459.055)

Missouri recognizes living wills under the Missouri Durable Power of Attorney for Health Care Act and Life Support Declarations Act, which allow individuals to create advance directives regarding their healthcare decisions.

Declaration Requirements (Missouri Revised Statutes § 459.015)

A living will in Missouri must be in writing, signed by the declarant or by someone at the declarant's direction in their presence, and witnessed by two individuals who are not related to the declarant by blood or marriage.

Witness Qualifications (Missouri Revised Statutes § 459.015)

Witnesses to a living will cannot be related to the declarant by blood or marriage, entitled to any portion of the declarant's estate, directly financially responsible for the declarant's medical care, or the attending physician or an employee of the attending physician or healthcare facility.

Notarization Alternative (Missouri Revised Statutes § 459.015)

In lieu of being witnessed, a living will declaration may be acknowledged before a notary public.

Terminal Condition Definition (Missouri Revised Statutes § 459.010)

The living will must address situations where the declarant has a terminal condition, defined as an incurable or irreversible condition which, in the opinion of the attending physician, is such that death will occur within a short time regardless of the application of medical procedures.

Persistently Unconscious State (Missouri Revised Statutes § 459.010)

The living will should address situations where the declarant is in a persistently unconscious state, defined as a permanent and irreversible condition in which there is no reasonable medical expectation of recovery and which is characterized by a complete absence of voluntary cognitive functions.

Revocation Provisions (Missouri Revised Statutes § 459.020)

The living will must acknowledge that it can be revoked at any time and in any manner by which the declarant is able to communicate their intent to revoke, without regard to mental or physical condition.

Pregnancy Limitations (Missouri Revised Statutes § 459.025)

In Missouri, a living will may not be honored if the declarant is pregnant and the fetus could develop to the point of live birth with continued application of life-sustaining procedures.

Physician Non-Compliance (Missouri Revised Statutes § 459.030)

The living will should address the process for transferring care if a physician is unwilling to comply with the declarant's wishes due to reasons of conscience or hospital policies.

Artificial Nutrition and Hydration (Missouri Revised Statutes § 459.010)

The living will must specifically address whether artificial nutrition and hydration should be withheld or withdrawn, as Missouri law requires explicit instructions regarding these procedures.

Healthcare Provider Immunity (Missouri Revised Statutes § 459.045)

The document should acknowledge that healthcare providers acting in accordance with the living will are immune from civil and criminal liability for actions taken in good faith.

Patient Self-Determination Act Compliance (42 U.S.C. § 1395cc(a)(1)(Q))

The living will should comply with the federal Patient Self-Determination Act, which requires healthcare facilities to provide information about advance directives and honor valid directives.

HIPAA Authorization (45 CFR § 164.508)

The living will should include authorization for the release of medical information to designated healthcare agents in compliance with the Health Insurance Portability and Accountability Act.

Organ Donation Wishes (Missouri Revised Statutes § 194.210-194.294)

The living will should address the declarant's wishes regarding organ donation in accordance with the Uniform Anatomical Gift Act as adopted in Missouri.

Pain Management Provisions (Missouri Revised Statutes § 459.010-459.055)

The living will should include provisions for pain management and comfort care, even if life-sustaining treatment is withheld or withdrawn.

Specific Medical Interventions (Missouri Revised Statutes § 459.010-459.055)

The document should address specific medical interventions such as cardiopulmonary resuscitation (CPR), mechanical ventilation, dialysis, and surgery, allowing the declarant to accept or refuse each intervention.

Mental Health Treatment Preferences (Missouri Revised Statutes § 632.300-632.475)

The living will may include preferences for mental health treatment in the event the declarant becomes incapacitated and requires psychiatric care.

Religious or Spiritual Preferences (Missouri Revised Statutes § 459.010-459.055)

The living will may include provisions for religious or spiritual care and rituals that the declarant wishes to receive during end-of-life care.

Coordination with Durable Power of Attorney (Missouri Revised Statutes § 404.800-404.872)

The living will should address its relationship with any existing durable power of attorney for healthcare, clarifying which document takes precedence in case of conflict.

Out-of-State Recognition (U.S. Constitution, Article IV, Section 1)

The living will should include provisions addressing its validity if the declarant is transferred to a healthcare facility in another state, in accordance with the Full Faith and Credit Clause of the U.S. Constitution.

Frequently Asked Questions

A living will is a legal document that outlines your preferences for medical care if you become incapacitated and unable to communicate your wishes. Unlike a regular will (last will and testament) that distributes your property after death, a living will applies while you're still alive but unable to make decisions. It specifically addresses healthcare matters such as life-sustaining treatments, pain management, and end-of-life care. A living will is often part of a broader advance directive that may also include a healthcare power of attorney, which designates someone to make medical decisions on your behalf.

For married individuals with children, a living will is crucial because it prevents your spouse and children from having to guess about your medical preferences during an already stressful time. Without clear guidance, family members may disagree about what you would want, potentially causing conflict and additional emotional strain. A living will provides clear instructions that can prevent family disputes and ensure your spouse isn't solely burdened with difficult decisions. It also sets an example for your children about responsible planning and can spark important family conversations about values and end-of-life wishes.

For high net worth individuals, a living will works alongside your financial planning to protect your assets in several ways. Without clear healthcare directives, prolonged medical interventions that you might not have wanted could deplete significant assets intended for your heirs or philanthropic goals. A living will helps prevent unnecessary medical expenses and preserves your estate according to your wishes. Additionally, it works in conjunction with other estate planning tools to ensure a comprehensive approach to protecting your wealth. By clearly documenting your healthcare preferences, you also reduce the risk of legal challenges or family disputes that could impact your estate.

Single individuals without children may actually have an even greater need for a living will. Without a spouse or children who would typically be consulted about medical decisions, healthcare providers might turn to more distant relatives who may not know your wishes. A living will ensures your preferences are legally documented and followed. Additionally, you can use a healthcare power of attorney (often created alongside a living will) to designate a trusted friend, partner, or relative to make decisions on your behalf. This is particularly important for unmarried partners who would otherwise have no legal standing in medical decision-making.

A living will allows you to address a wide range of medical interventions, including: cardiopulmonary resuscitation (CPR), mechanical ventilation, tube feeding, dialysis, antibiotics and other medications, comfort care preferences, organ and tissue donation, and do not resuscitate (DNR) orders. You can specify under what conditions you would want these treatments initiated, continued, or withdrawn. Many living wills also address your preferences regarding pain management and palliative care to ensure comfort even if you decline certain life-sustaining treatments.

Creating a legally valid living will typically involves these steps: 1) Research your state's requirements, as laws vary by jurisdiction; 2) Obtain the proper forms from your state's health department, hospital, or an attorney; 3) Consider consulting with healthcare providers about medical scenarios and options; 4) Clearly document your wishes regarding various treatments; 5) Follow your state's signature requirements, which usually include witnesses and/or notarization; 6) Distribute copies to your healthcare providers, designated healthcare agent, and close family members; 7) Store the original in an accessible location. While you can create a living will using online templates, consulting with an attorney who specializes in estate planning is recommended, especially for complex medical situations or if you have substantial assets.

Yes, you can and should review and update your living will periodically. Major life events such as marriage, divorce, a significant health diagnosis, or changes in your values or preferences are good times to revisit your document. To update your living will, you'll need to complete a new document following the same legal formalities as the original. Once executed, be sure to destroy all copies of the old document and distribute the updated version to everyone who had a copy of the previous version. It's important to communicate these changes to your healthcare providers and loved ones to ensure everyone is aware of your current wishes.

A living will works as part of a comprehensive estate plan. It typically functions alongside a healthcare power of attorney (or healthcare proxy), which names someone to make medical decisions for you. Together, these documents are often called an advance directive. Other important complementary documents include a financial power of attorney (for managing finances during incapacity), a HIPAA authorization (allowing access to medical records), and a traditional will or trust (for distributing assets after death). For a complete estate plan, especially for those with significant assets or complex family situations, these documents should be created with professional guidance to ensure they work together seamlessly.