What is it?

A legal document that indicates whether you wish to have life-sustaining treatment to keep you alive if you are in a permanent coma or at end of life and cannot express your wishes directly to your physician. This is the document that Terry Schiavo did NOT have.

Why do I need them?

The Living Will indicates whether or not you will be kept alive with a feeding tube giving you food and water if that is the only thing keeping you alive.

What our office needs to know:

You must make a decision about whether or not you wish to have a feeding tube providing food and fluids in the event you are permanently unconscious. We also need to know the names and phone numbers of two or three family members or others who you would like to have notified if you are in this situation. 

Where should I keep them?

Keep the original Living Will with your important papers and give a copy to your Healthcare Power of Attorney.

Many of you already made a decision about anatomical gifts which is indicated on your driver’s license. If not, in order for our office to complete this document and submit it to the Ohio Bureau of Motor Vehicles you will need to provide the following information:

• You are asked to decide if you want all of your possible body parts to be used or you may specifically state only the parts you want to be used (heart, lungs, liver, kidneys, pancreas, skin, bones, ligaments, heart valves, veins and eyes).
• You are asked to decide if you want your body parts used for any reason under Ohio Law or you may specifically state only the reasons you choose (transplantation, therapy, research, education or advancement of medical or dental science).

You will name one individual and two alternates to complete this document (normally your spouse will be the first agent).

• A Health Care Power of Attorney is a document that allows you to name a person to act on your behalf to make health care decisions for you if you become unable to make them for yourself.
• The form provides a section where you may write specific instructions and impose additional limitations that you may consider appropriate to document (e.g. you do not want any blood transfusions, contact your clergyman if possible).
• This document also provides a specific waiver of your privacy rights for protected Health Care information (HIPAA) so that your named agent will have access to your Health records.

Your Living Will and Health Care Power of Attorney contain a statement that this document has been provided to you.

• Ohio’s Do-Not-Resuscitate Law (DNR) gives individuals the opportunity to exercise their right to limit care received in emergency situations in special circumstances. “Special circumstances” include care received from emergency personnel when 911 is dialed. The law authorizes a physician to write an order letting health care personnel know that a patient does not wish to be resuscitated in the event of a cardiac arrest (no palpable pulse) or respiratory arrest (no spontaneous respirations or the presence of labored breathing).
• This Document is provided to you and must be completed by you Physician.