The term “living will” has entered the national consciousness in part due to high-profile court battles to determine the end-of-life medical treatment provided to patients. On one side of the legal battle are family members insisting that the patient would have wanted every conceivable effort made to prolong his or her life. Other family members demand that the patient would have wanted artificial life-sustaining procedures withdrawn and allowed a dignified death. The one person who could settle the matter is incapable of doing so because of a comatose or brain-dead condition.
Similar dilemmas are commonly faced by families all over the country. While most of these matters do not escalate into legal battles, they are fraught with difficulty and provide fertile ground for hard feelings among family members, often creating divisions that last a lifetime.
For more than thirty years Colorado law has allowed individuals to set out in advance his or her desires to accept or reject medical or surgical treatment. The technical name for a living will under Colorado statute is an “Advanced Directive for Medical/Surgical Treatment.”
For a living will to go into effect in an end-of-life situation, the patient must be (1) incapacitated and (2) determined by two qualified medical professionals to be in either a terminal condition or a persistent vegetative state. A terminal condition is defined as “an incurable or irreversible condition for which the administration of life-sustaining procedures will serve only to prolong the dying process.” A persistent vegetative state is defined “by reference to the criteria and definitions employed by prevailing community medical standards of practice.” This definition intentionally leaves the determination in the hands of the medical providers rather than the courts.
Colorado statute allows the patient to choose one of three options should they be incapacitated and in a terminal condition or a persistent vegetative state. A patient may direct medical providers to: (1) withdraw or withhold life-sustaining treatment, (2) provide life-sustaining treatment for a period of time specified by the patient, after which treatment would be withdrawn, or (3) continue life-sustaining procedures as long as medically feasible.
A life-sustaining procedure is “any medical procedure or intervention that, if administered to a qualified patient, would serve only to prolong the dying process, and shall not include any medical procedure or intervention for nourishment of the qualified patient or considered necessary by the attending physician or advance practice nurse to provide comfort or alleviate pain.”
Regardless of the directions set forth in a living will, medical providers are not limited in their ability to administer medication or employ other methods designed to reduce or eliminate pain.
The living will is an important part of any estate plan. It can remove the burden from a person’s loved ones, providing clear instructions for them over your end-of-life care.