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What happens when there is no living will?

For decades, planning for serious illness and end of life involved two approaches.  First, clients used “advanced directives”, otherwise known as a living will, under which a person could direct treatment or lack of treatment in certain limited cases, usually limited to terminal illness and persistent vegetative state (PVS).  Second, clients could designate decision-making when they could not to an agent under a “health care power of attorney”.  However, for various reasons, medical practitioners have at various times ignored these documents.  One theory is that the documents were written by attorneys and were not understandable by doctors.

In 2010, the legislature enacted a statute allowing the use of detailed medical orders regarding the scope of treatment, known as “MOST” directives or orders.  Under the new statute, a client may create a document detailing the proposed medical treatment or lack of treatment under various scenarios discussed between the client and her doctor.  The document is then signed by patient and doctor.  The doctor’s signature makes it a medical order, and the client/patient’s signature confirms her desire that such instructions be followed.

At DRC, we usually work with clients to craft a medical or healthcare power of attorney or a living will but occasionally we work with clients to design and prepare a MOST directive.

MWR