A living will is an important document that specifies how a person wishes to be treated in the event of a serious illness or medical emergency if they are no longer able to express their wishes themselves. Counseling on a living will helps the patient clearly and definitively formulate their preferences regarding medical treatments and interventions. This provides guidance to relatives and doctors when the person concerned can no longer make decisions due to illness or accident.

Goals of Living Will Counseling

1. Preserving self-determination: A living will ensures that the patient’s wishes are respected even when they can no longer express them verbally. This guarantees decisions are made based on the individual’s own values and preferences.
2. Avoiding unnecessary medical interventions: Clear specifications of preferences can help avoid unnecessary or undesired medical treatments. This includes, for example, the use of life-sustaining measures such as ventilation or artificial nutrition.
3. Relieving relatives and doctors: A living will provides clear instructions to relatives and medical personnel on how to proceed in an emergency. It helps make difficult decisions and avoid potential conflicts between the patient’s wishes and the family’s views.
4. Legal security: The document is legally binding, obligating doctors to follow the patient’s will as outlined in the living will. This offers legal clarity and assurance for the patient, their relatives, and the doctors.

Contents of a Living Will

In a living will, various aspects of medical treatment in the event of a severe illness or injury are outlined. Key points include:

1. Life-sustaining measures: The patient can specify whether they want to insist on life-sustaining measures such as artificial ventilation or cardiopulmonary resuscitation in the event of irreversible coma, severe brain damage, or an incurable disease, or whether they wish to decline these interventions.
2. Artificial nutrition and hydration: The will can specify whether the patient wishes to receive artificial nutrition or hydration in situations where they can no longer eat or drink on their own, or whether they refuse such measures.
3. Palliative care: The patient can indicate whether they wish to receive palliative treatment in the advanced stages of an incurable illness to alleviate symptoms and improve quality of life, even if this shortens the lifespan.
4. Organ donation: A living will can also include decisions regarding organ donation, both during life and after death.
5. Refusal of certain treatments: The patient can specify which medical procedures they decline in specific situations, such as surgeries or intensive care treatments.
6. Care and support: Preferences regarding the type of care and support in case of severe illness or old age can also be expressed.

Importance of Counseling

Counseling on a living will enables the patient to explore the available options and make informed decisions. This is particularly important since many people are unaware of the medical measures available in emergencies or their potential effects.

1. Clarity about medical terms: Legal and medical terms can often be difficult for laypersons to understand. Counseling helps clarify these terms and ensure the patient fully understands the consequences of their decisions.
2. Customization to personal values and preferences: Every individual has unique ideas about how they wish to be treated in the event of a serious illness. Counseling helps clearly articulate these wishes and incorporate them into the document.
3. Consideration of individual life circumstances: The patient’s personal life situation, such as existing serious illnesses or age, is considered during counseling to tailor decisions to their individual needs and preferences.
4. Advice on power of attorney and care directives: A living will is often created alongside a power of attorney and care directive. These complementary documents regulate who may make decisions on behalf of the patient in case of incapacity and the legal framework for caregiving.

Legal Aspects of a Living Will

A living will is legally binding in Germany if it meets certain requirements. It must be personally signed and, ideally, dated. Regular reviews and updates are also important to ensure it reflects the patient’s current wishes.

1. Binding nature: Doctors are obligated to respect the wishes outlined in the living will as long as they are legally and medically justifiable. The only exception is if the will conflicts with medical standards.
2. Documentation and storage: It is recommended to store the living will with a trusted relative or family doctor to ensure it is quickly accessible in an emergency.

Conclusion

Counseling on a living will is an essential step for individuals wishing to clearly and definitively outline their medical preferences in the event of severe illness or injury. It helps preserve the patient’s autonomy, avoid unnecessary burdens, and provide clear instructions to relatives and treating physicians.