First of all, it is important to note that the living will is also known under a variety of other names, including “advance directive", “health care directive”, or “directive to physicians”. In general, these terms refer to the same document.

The living will is a written document containing your wishes regarding medical care in the event that you become incapable of making decisions or expressing yourself. For example, you can indicate that you do not want to be kept alive using a respirator.

The general right of a person to consent to or to refuse healthcare is what gives rise to the living will. The living will helps guide the persons that must make decisions instead of you when you are unable to express your choices. To learn more, read our Infosheet called Consent to care.

In Quebec, there is no law that deals specifically with the living will. However, this document does have a legal value because Quebec law grants individuals the right to consent to or refuse care. The living will is an extension of this right. In effect, this document permits you to indicate your wishes in advance regarding the care that you want to receive if you become unable to make health decisions.

As well, the law specifically mentions that people who may consent on your behalf, when you are no longer able to do so, must consider the wishes you expressed previously. In this regard, the living will creates an obligation.

Therefore, this document has the same value as other forms of consent given by a person regarding medical care. As such, it must be respected based on the circumstances. For example, if a lot of time has elapsed between the preparation of the living will and the moment it is required, its contents may no longer be up-to-date.

In summary, your living will must be taken into consideration, but it does not unconditionally bind anyone.

The living will must be dated and signed. Preferably, the document should also be drafted before a witness.

In addition, you must be capable of making your own decisions at the moment in time when you prepare the will. This means that you must be able to express your consent or refusal with a full understanding of the situation. Therefore, a person suffering from the advanced stages of Alzheimer’s cannot, in principle, write such a document because his capacity to express his wishes is greatly altered.

To summarize, there exists no form or specific formality for a living will, other than the requirement for a signature and date. You therefore have the freedom to prepare it as you wish and to include the elements you feel are relevant. You may even draft the living will in the form of a simple letter.

As mentioned above, you have the final say regarding the contents of this document.

However, it may be helpful to know that the living will generally addresses two main issues.

First, you may indicate your refusal for medical personnel to administer a treatment that artificially prolongs your life. To this end, it is prudent to specify the treatments you wish to refuse. The use of vague terms in your living will can create confusion for the healthcare workers, as well as for your friends and family. In effect, you and your doctor may disagree on what constitutes excessive medical intervention. So, it is a good idea to specify whether you refuse or accept to receive chemotherapy, to be revived, to be maintained on life support, etc.

The second main issue is that of pain relief. You may want to indicate that you want your pain relieved even if this has the consequence of shortening your life or, on the contrary, that the medical personnel should limit their palliative intervention.

First of all, the term “will” may create confusion. The “living will” differs from the will in which you set out the distribution of your property and assets following your death. Basically, the main difference is that the living will takes effect during your life, if you become incapable of expressing your wishes, while the other type of will takes effect at the moment of death.

Consequently, the living will is used only when you are no longer able to express your wishes. For example, this might involve incapacity linked to illness, a state of coma, or a total incapacity to express yourself verbally or physically.

Here is an example of a situation where the living will may be useful: Marcel must undergo surgery in a few days. His doctor warns him that the operation involves significant risks and it is possible that he will remain in a coma after the surgery. Marcel decides to write a living will expressing his wishes for the end of his life, knowing that he may not be able to do so after the operation.

Absolutely. At any time, you may modify or even destroy your living will. Modifications may be written or made verbally, but written changes are preferable. Also, it’s advisable to inform your family, friends and the medical staff of the changes.

When the time comes to implement your modified living will, your family and the medical staff will consider whether you were capable of understanding the implications of the changes when you made them.

For example, you draft your living will when you’re 60 years old and your intellectual faculties are intact. A number of years later, you make changes to your living will while you’re going through a serious depression and experiencing a progressive loss of your intellectual faculties. When the time comes to decide whether or not to respect the changes, it is likely that family or medical staff will take into account your mental health at the time you modified the will.

The attending doctor is not obliged to respect your living will. He must take it into consideration, though.

Furthermore, the doctor must verify with you whether your living will still conveys your wishes, to the extent that this is possible. After all, a number of years may have elapsed since the document was drafted. The doctor must try to find out if your wishes are the same as they were when you first created your living will.

Even if you have a living will, the doctor still has a responsibility to exercise professional judgment and to act wisely under the circumstances. For example, a doctor cannot invoke your living will as a pretext for not administering treatment without actually assessing your situation. First, the doctor evaluates your medical condition, and then he considers your wishes as expressed in the living will.

Finally, the living will does not replace dialogue, the essential element at the heart of the medical relationship between doctor, family, and patient (where possible).

If one day you are not able to consent to care that the medical staff would like to administer, someone will have to consent on your behalf. In such a scenario, your living will becomes useful for your friends and family. This document is an excellent reference point for the people who will have to make difficult choices, while trying to respect your wishes.

As with the medical staff, your family and friends must take into account the circumstances when deciding what to do. Your living will does not liberate them from their obligation to make treatment decisions based on the particular situation. For example, your relative should not refuse treatment on your behalf based solely on the contents of your will, without carefully considering your medical situation.

No. There is no specific formality required for the preparation of a living will. Consequently, you are free to write it yourself or with the help of a person of your choice.

However, legal advisors, lawyers, and notaries can provide you with sound advice on drafting the document, particularly with respect to clarity.

Even if you are not legally bound to give a copy to anyone, it is a good idea to do so. After all, if no one is aware of the existence of your living will, it is unlikely to be taken into consideration. Rather than giving a copy to a friend or family member, you may simply let them know where to find it if the need arises.

As well, it is suggested you add a copy of your living will to your medical record. In this manner, the medical personnel will be aware of your wishes.