A Last Will for when you are alive?

[john10001]

A last will and testament are usually written by you to convey your wishes for after you pass away.

I just wondered what there is legally that you can use to convey your wishes should you be alive but incapacitated?

Is there some similar sort of powerful legal document you can use so you do not leave any decision making in the hands of others?

I've been thinking I need to update my will recently just in case but I also thought that some other legal document would be good for conveying my wishes should I be incapacitated or in a coma or anything like that. I wouldn't want a relative killing me off or an NHS doctor signing a Do Not Resuscitate order on my behalf.

Unfortunately, there was a case of this only in the last two weeks were NHS doctors have been asking older people to sign DNR orders and one old guy who refused the doctor signed it for him without his consent or permission which is absolutely disgraceful.

Although I appreciate that not all doctors and nurses are like this and most do the best job they can in difficult circumstances and despite the disadvantage of an appalling State-run healthcare monopoly, I really don't trust the Government (NHS) with my healthcare and want some sort of legal document that spells everything out that I will and won't allow with my health and life.

[JohnB]

Resarch a "living will" https://www.ageuk.org.uk/information-ad ... decisions/

[pochisoldi]

First Steps:
Talk to your wife/husband/civil partner and "have that discussion".
Make sure that they know what your wishes are, and make sure you understand how they might feel about having to act on/carry out/pass on your instructions.
Things to consider, organ donation (yes?, no?, keep me alive until they are ready before letting me go?) , "do not resuscitate". "what if I end up in a permanent coma/persistent vegetative state", "Keeping me alive so people can say goodbye" - how long, for whom?

Note that this needs to be a two way thing - about how "you" want your life to end, and how those left behind may

The last one is probably the most important - you want to make sure that your partner can make the right decision without spending the rest of their lives thinking "perhaps I should have".

Such wishes expressed via a "next of kin" are normally compelling, especially if the "next of kin" is close, but not necessarily binding on whoever has to make the decision.

Formal method:
1) Create and register a Health and Welfare Lasting Power of Attorney (LPA).
https://www.gov.uk/lasting-power-attorn ... th-welfare

Doing this means that the people "to whom it concerns" must listen to whoever your attorney.
Note that a property/financial affairs LPA and a Health and welfare LPA can appoint different people to do each "job".

As previously noted in the thread
2) Create a living will
http://www.nhs.uk/Planners/end-of-life- ... tment.aspx

It would pay to ensure that:
1) the living will and LPA do not conflict
2) You've gone through the first steps

Fail to do either of those, and someone could go to the Court of Protection to get a decision made about a specific course of treatment.

Sorry if this seems a bit of a brain dump - to a certain extent it describes what I should be doing and need to get around to, to make it easier for others if/when the worst happens.

PochiSoldi

[Dod101]

I was going to quote the 'Living Will' as well. It is actually quite commonly advised by a decent lawyer. I think I have one and certainly my late wife when she was diagnosed with a life threatening cancer had one. It covers whether you want the Do Not Resuscitate instruction or not, who is to make medical decisions in the event that the person is unable to do so himself and anything else you want to happen in the sad event that you are unable to take these decisions yourself. Very relevant for now.

I would hope that doctors signing a DNR would be very rare and I am certain they should not be doing that. On the basis of the Living Will, the medics have a DNR form which you should complete and keep in an accessible place because, for instance, if you have to be taken off by an ambulance crew in the middle of the night they need to know there and then so there is no point in the DNR form lying locked in a desk drawer.

The other thing and quite separate item is a Power of Attorney. Pochisoldi has written in more detail but I will leave my contribution, written from personal experience.

Dod

[Itsallaguess]

On the basis of the Living Will, the medics have a DNR form which you should complete and keep in an accessible place because, for instance, if you have to be taken off by an ambulance crew in the middle of the night they need to know there and then so there is no point in the DNR form lying locked in a desk drawer.

I'm not quite sure what leverage such things possess, but it seems that 'Do Not Resuscitate' tattoos are very much a thing nowadays -

https://www.google.com/search?q=do+not+resuscitate+tattoo&tbm=isch

I'd imagine that a similar 'Please Do Resuscitate' tattoo might also help convey someone's personal requirements, although I'd urge anyone thinking about getting that particular phrase inked on to perhaps leave as little space as possible between the second and the third words....

Cheers,

Itsallaguess

[Dod101]

I would imagine that a tattoo would be used to guide the medics and they might be very glad to have it but in a perfect world most would probably want to check with the next of kin as well.

But a tattoo is unlikely to have been done under duress. A Living Will usually covers more than just the DNR instruction though.

Dod

[john10001]

Thank you, guys!

It looks like the Living Will may be the way to go for me as well as the Last Will.

I don't think I will be giving Power of Attorney to anyone. Unless it can be restricted to only carry out my precise instructions in a Living Will and Last Will by someone who won't be emotionally involved.

I don't want anyone else to convey my wishes. Even if there is someone you trust it is very easy for other people to forget, to change over time, to do what they want or what someone else wants or pressures them about instead of what you want.

I wonder how a living will and last will can be witnessed and signed while in lockdown?

[PinkDalek]

I wonder how a living will and last will can be witnessed and signed while in lockdown?

https://www.bbc.co.uk/news/business-52215141

[rhialto]

I wouldn't want a relative killing me off or an NHS doctor signing a Do Not Resuscitate order on my behalf.

The legal onus on doctors in England currently is to discuss the possibility of a DNR order with the patient. The doctor then takes a decision about it - you can't force anyone to attempt resuscitation on you if they don't think it's in your best interests.

[GrahamPlatt]

“I don't think I will be giving Power of Attorney to anyone. Unless it can be restricted to only carry out my precise instructions in a Living Will and Last Will by someone who won't be emotionally involved”

POAs expire on death. This would only allow someone to act on the terms of your living will. Once dead, your nominated executors deal with your last will. Might be worth you downloading the notes and forms relating to POAs & having a look through. (https://www.gov.uk/power-of-attorney) - there are two, one for financial affairs, one for health & welfare.

[Dod101]

I wouldn't want a relative killing me off or an NHS doctor signing a Do Not Resuscitate order on my behalf.

The legal onus on doctors in England currently is to discuss the possibility of a DNR order with the patient. The doctor then takes a decision about it - you can't force anyone to attempt resuscitation on you if they don't think it's in your best interests.

DNR's are typically discussed when someone has a terminal illness such as an incurable cancer because of course the basic task of a doctor is to preserve life or at least postpone death, which is the more accurate way of looking at it. By the time it comes to requiring resuscitation you will unlikely be in a position to influence matters very much. The DNR order is or at least was to avoid the patient being kept alive more or less artificially. The patient may not want that either for him/herself or to have the relatives to have to go through that. It may be that with the pressures of the Covid 19 virus things have been turned on their head but it is not for a doctor to persuade a patient to sign a DNR order or at least it should not be for a doctor to do that or put the least pressure on the patient.

Not sure what you mean by the doctor then takes a decision about it. If the patient signed the DNR the decision is made. The assumption, in fact the duty of a doctor without any DNR in place, is to attempt resuscitation if it is deemed to be in the interests of the patient which usually means if there is a good chance of as I said above, postponing death.

I was through this with my wife 4 years ago.

Dod

[rhialto]

DNR's are typically discussed when someone has a terminal illness such as an incurable cancer because of course the basic task of a doctor is to preserve life or at least postpone death, which is the more accurate way of looking at it.

I think we disagree on the basic task of a doctor, as does the GMC. The (UK) duties of a doctor are set out at https://www.gmc-uk.org/ethical-guidance ... f-a-doctor. That doesn't list preserving life or postponing death, but rather "Make the care of your patient your first concern" -sometime postponing death is not best for the patient.

By the time it comes to requiring resuscitation you will unlikely be in a position to influence matters very much.

Quite - which is why it's important to have these discussions early. Best practice is to discuss this with anyone admitted to hospital (or a nursing home or similar environment). I'm under no illusions that best practice is usually followed.

The DNR order is or at least was to avoid the patient being kept alive more or less artificially.

No, a decision not to attempt resuscitation is to avoid subjecting a patient (or their dead body) to a violent, intrusive, set of interventions which usually don't have the effect desired and are often futile. There's plenty of people who are being kept alive artificially for whom resuscitation wouldn't be attempted if there were eg a cardiac arrest. A decision not to resuscitate is just that - it doesn't preclude other appropriate medical or surgical interventions.

The patient may not want that either for him/herself or to have the relatives to have to go through that. It may be that with the pressures of the Covid 19 virus things have been turned on their head but it is not for a doctor to persuade a patient to sign a DNR order or at least it should not be for a doctor to do that or put the least pressure on the patient.

There's no need for a doctor to persuade a patient to sign anything in this circumstance. A doctor can make the decision him or herself. The onus on the doctor is (where possible) to have a frank discussion with the patient, so the patient can take an informed view as to whether they want rescuscitation to be attempted should the situation arise. That view will inform the doctors decision whether it should be provided.

Not sure what you mean by the doctor then takes a decision about it. If the patient signed the DNR the decision is made. The assumption, in fact the duty of a doctor without any DNR in place, is to attempt resuscitation if it is deemed to be in the interests of the patient which usually means if there is a good chance of as I said above, postponing deat
Dod

Quite - if the patient actively indicates they don't want to be resuscitated that's clear. But even if a patient does want to be resuscitated it's within the discretion of the treating doctor to decide that such an intervention would be futile, or even harmful, and not attempt it. If there's no indication that a decision has been considered it's safer to start resuscitation until a firm view can be taken - my experience is that the patient usually preempts that process by not responding to resuscitation attempts.

To put "which usually means if there is a good chance of as I said above, postponing death" in context, the majority of patients for whom cardiac resuscitation is attempted in hospital do not survive to leave hospital. It's 20 years since I was on a hospital crash team, but our success rate was less than 20% of patients surviving the resuscitation process.