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When considering the future and the possibilities that it holds, particularly concerning health and personal care, many New Yorkers turn to the Living Will form as an essential tool for ensuring their wishes are respected and followed. This document allows individuals to express their preferences about receiving medical treatment in situations where they might not be able to communicate their wishes due to severe illness or incapacity. The New York Living Will form covers various critical aspects, including decisions on life-sustaining treatments, end-of-life care options, and the appointment of a healthcare proxy or agent who can speak on behalf of the individual if they're unable to do so themselves. By filling out this form, New Yorkers can provide clear instructions that guide family members and healthcare providers, minimizing uncertainties and conflicts during challenging times. Importantly, while dealing with such sensitive decisions can be challenging, the clarity provided by a Living Will can offer peace of mind to both the individual involved and their loved ones, knowing that the care choices align with personal values and preferences.

Example - New York Living Will Form

New York Living Will

This Living Will is designed under the authority of the New York Health Care Proxy Law, allowing individuals to express their wishes regarding life-sustaining treatments, including measures they do or do not want to be taken to extend their life.

DECLARANT INFORMATION

I, _______________ [name], residing at _______________ [address], City of _______________, State of New York, being of sound mind, do hereby declare this document as my Living Will.

DATE OF BIRTH:

_________________

1. DECLARATION REGARDING LIFE-SUSTAINING TREATMENT

In the event I am unable to communicate my wishes directly, and I am in a medical condition determined to be either terminal or permanently unconscious by two physicians, I direct that:

  • All treatments which would only prolong the dying process be withheld or withdrawn.
  • I wish to receive maximum pain relief, including any pain relief medication, even if it hastens my death.
  • I do NOT wish to receive the following treatments: _______________ [List any specific treatments you do not want. For example, "mechanical ventilation," "tube feeding," "antibiotics," etc.]

2. ADDITIONAL HEALTH CARE INSTRUCTIONS

I further specify the following preferences about my health care: _______________ [Specify any additional health care instructions. For example, hospital of preference, primary physician, allergies, religious or spiritual wishes related to health care.]

3. APPOINTMENT OF HEALTH CARE AGENT

While this document does not appoint a Health Care Proxy, New York law allows for the appointment of a Health Care Agent to make decisions on your behalf if you cannot make them yourself. Consider completing a Health Care Proxy form in addition to this Living Will.

SIGNATURE OF DECLARANT

I affirm that this Living Will reflects my desires concerning treatment decisions:

Signature: _____________________ Date: _______________

WITNESS STATEMENT

We, the undersigned, declare that the person signing this Living Will:

  1. Is personally known to us or has provided proof of identity.
  2. Appeared to be of sound mind and not under duress, fraud, or undue influence.
  3. Signed or acknowledged their signature on this Living Will in our presence.

Witness 1: _____________________ Date: _______________

Witness 2: _____________________ Date: _______________

NOTARY PUBLIC (If required)

This section should be completed if a notary public is required to witness the signing of this Living Will in New York.

State of New York )

County of _______________ )

Subscribed and sworn before me this _______________ day of _______________, 20__.

Notary Public: _______________

Commission Expires: _______________

Form Specifics

Fact Name Description
Purpose The New York Living Will form allows individuals to document their preferences regarding medical treatments and interventions at the end of their life, specifically addressing circumstances where they can no longer communicate their wishes due to incapacity.
Governing Law(s) The New York Health Care Proxy Law primarily governs the use and recognition of living wills within the state, although New York does not have a statute explicitly for living wills. Instead, it acknowledges them under common law.
Key Components In addition to specifying preferences for medical treatments or interventions, a New York Living Will can include instructions regarding organ donation, the designation of a health care agent, and post-death decisions such as burial or cremation preferences.
Validity Requirements For a Living Will to be considered valid in New York, it must be signed by the declarant and witnessed by two adults who are not beneficiaries of the declarant’s estate. The witnesses must attest to the declarant’s mental competence and voluntary execution of the document.

How to Write New York Living Will

Preparing a Living Will is a significant step in planning for future healthcare decisions. This document allows individuals to outline their wishes regarding medical treatment in scenarios where they are unable to communicate their decisions themselves. The process of filling out a New York Living Will form is straightforward, but it requires careful consideration and precision to ensure that one's wishes are clearly understood and can be followed. After completing the form, make sure to review it with a healthcare provider and a legal advisor, then distribute copies to trusted family members and any designated healthcare proxies to guarantee your wishes are honored.

Steps for Filling Out the New York Living Will Form

  1. Start by reading the entire form carefully to understand all the sections and what information is required.
  2. Enter your full legal name and address at the beginning of the document to identify yourself as the declarant.
  3. Clearly specify your wishes about medical treatments and life-sustaining measures in the appropriate sections. Be as detailed as possible to avoid any ambiguity about your preferences.
  4. Include specific instructions about receiving or refusing treatments such as resuscitation, mechanical ventilation, tube feeding, and dialysis if these situations apply to your health concerns.
  5. If you have firm wishes about pain relief, make sure to address your preferences for receiving medication to alleviate pain, even if these treatments may hasten death.
  6. Appoint a healthcare proxy by providing the name, relationship, and contact information of the person authorized to make medical decisions on your behalf if you are unable to do so. This step is crucial for ensuring your wishes are honored.
  7. Discuss your Living Will with the appointed healthcare proxy to ensure they understand and are willing to abide by your wishes.
  8. Sign and date the form in the presence of two witnesses who are not your appointed healthcare proxy or related to you by blood or marriage. The witnesses must also sign and date the form, attesting that you are of sound mind and not under duress or undue influence at the time of signing.
  9. Finally, keep the original document in a safe but accessible place. Distribute copies to your healthcare proxy, close family members, and your primary care physician to ensure that your wishes are known and can be easily accessed when needed.

After completing your Living Will, it's important to remember that your wishes can be revised at any time. Should you change your mind or if your health situation evolves, make sure to update your Living Will to reflect these changes, following the same process for ensuring your updated wishes are recognized and respected.

Things You Should Know About This Form

  1. What is a New York Living Will?

    A Living Will in New York is a legal document allowing individuals to outline their wishes regarding medical treatment and interventions in the event they become unable to make such decisions for themselves. This document typically covers preferences on life-sustaining treatments, end-of-life care, and other medical decisions when a person is deemed incapacitated.

  2. Who should have a Living Will?

    Every adult in New York who wishes to have control over their medical treatment in circumstances where they can no longer communicate their desires should consider creating a Living Will. It's especially vital for those with strong preferences about end-of-life care or those with specific medical conditions that could lead to incapacity.

  3. How is a Living Will created in New York?

    To create a valid Living Will in New York, the document must clearly articulate the individual's healthcare wishes and should be signed in the presence of two witnesses, who also need to sign the document. These witnesses should not be individuals who stand to benefit from the person's estate, to avoid any potential conflict of interest.

  4. What is the difference between a Living Will and a Health Care Proxy in New York?

    A Living Will focuses on specific wishes regarding medical treatments and interventions, while a Health Care Proxy appoints someone else (an agent) to make healthcare decisions on the individual's behalf. Many New Yorkers choose to have both documents to ensure comprehensive coverage of their wishes and the appointment of a trusted person to advocate for them.

  5. Can a Living Will be changed or revoked?

    Yes, a Living Will can be changed or revoked at any time by the individual who created it, as long as they are of sound mind. This can be done by creating a new document that outlines the new decisions and indicates that previous documents are revoked, or simply by physically destroying the document.

  6. Does a Living Will need to be notarized in New York?

    No, a Living Will does not need to be notarized in New York. However, it must be signed by two adult witnesses to be legally valid. The witnesses serve to confirm the authenticity of the signature and the voluntary nature of the document's creation.

  7. How does a Living Will become effective in New York?

    A Living Will becomes effective when the individual becomes unable to make healthcare decisions for themselves as determined by a medical professional. The medical team will consult the Living Will to guide the decisions regarding the individual’s care, in line with their previously stated wishes.

Common mistakes

Filling out a New York Living Will is a significant step in planning for future health care decisions. However, many people make mistakes during this process, which can lead to confusion or the document not being followed as intended. One common mistake is not providing clear instructions about the person's medical treatment preferences under various conditions. It's crucial to be as specific as possible to avoid any ambiguity that could leave loved ones and healthcare providers unsure of your wishes.

Another frequent error is neglecting to update the living will. A person's preferences for treatment might change due to various factors such as age, health status, or personal beliefs. Failing to reflect these changes in the living will can result in medical decisions that are not in line with the current wishes of the individual.

Not properly signing and witnessing the document is also a significant oversight. New York law has specific requirements for how a living will must be signed and witnessed to be considered valid. If these protocols are not followed, the document may not be legally recognized, potentially rendering it useless in a time of need.

Many individuals incorrectly assume that discussing their living will with family is enough and that formal documentation isn't necessary. This assumption can lead to disputes or confusion among family members and healthcare providers about what the individual’s true wishes are. A formally prepared living will is essential for ensuring that your healthcare preferences are known and can be legally upheld.

Failure to appoint a health care proxy or not informing the appointed proxy about their responsibilities and your wishes is another common mistake. The health care proxy is an individual chosen to make healthcare decisions on your behalf if you are unable to do so. Without clear communication and understanding, the proxy may be unprepared to make informed decisions that accurately reflect your preferences.

Not specifying under what conditions the living will should take effect could render it ineffective when needed most. It’s important to clearly define the circumstances under which the living will should guide your healthcare, such as in cases of terminal illness or permanent unconsciousness.

Lastly, many forget to distribute copies of their living will to relevant parties, including their health care proxy, family members, and healthcare providers. This oversight can result in your living will not being readily available in critical situations, thereby delaying the implementation of your healthcare preferences.

Documents used along the form

In the state of New York, when individuals seek to have control over their healthcare decisions, especially towards the end of their life, they often turn to a Living Will. This document is pivotal for expressing an individual’s desires regarding medical treatment when they're no longer able to communicate their wishes due to incapacity or terminal illness. However, to ensure a comprehensive healthcare plan, several other documents are typically utilized alongside a Living Will. Each plays a crucial role in safeguarding a person's medical preferences and legal rights.

  • Health Care Proxy: This document allows an individual to appoint a trusted person as their health care agent. This agent then has the authority to make health care decisions on behalf of the individual if they become unable to do so themselves.
  • Durable Power of Attorney: While similar to the Health Care Proxy in allowing someone else to make decisions, this document specifically grants an agent the power to make financial decisions on behalf of the individual.
  • Do Not Resuscitate Order (DNR): This critical document instructs health care providers not to perform CPR if an individual's breathing stops or if their heart stops beating.
  • Medical Orders for Life-Sustaining Treatment (MOLST): A MOLST form goes beyond a Living Will by providing specific instructions about certain life-sustaining treatments based on the individual’s current health condition.
  • Organ and Tissue Donation Consent Form: Indicates an individual’s consent to donate their organs and tissues upon death, which can be registered with the Health Department or indicated on a driver’s license.
  • HIPAA Release Form: This form gives health care providers permission to share an individual’s medical information with specified persons, often including the health care agent appointed in a Health Care Proxy.
  • Polst Form (Practitioner Orders for Life-Sustaining Treatment): Similar to the MOLST, this form is designed to ensure that a patient’s preferences for end-of-life care are understood and honored by healthcare providers.
  • Emergency Medical Information Form: Often carried by individuals, this form contains crucial healthcare information, such as drug allergies, conditions, medications being taken, and emergency contacts, so that first responders can access it quickly in an emergency.

Together, these documents form an integral part of a well-considered end-of-life plan. They offer peace of mind to the individual and their loved ones by ensuring that healthcare decisions reflect the individual's desires and are made by trusted agents. New York residents are encouraged to familiarize themselves with these forms and consider incorporating them into their healthcare planning process.

Similar forms

The New York Living Will form shares similarities with the Durable Power of Attorney for Health Care. Both documents allow individuals to outline their preferences for medical care, but while a Living Will specifies the types of medical treatments and life-sustaining measures an individual wants or doesn't want, a Durable Power of Attorney for Health Care appoints an agent to make healthcare decisions on the individual's behalf when they are unable to do so. This distinction underscores the complementary nature of the two documents in comprehensive healthcare planning.

Another comparable document is the Medical Orders for Life-Sustaining Treatment (MOLST). Similar to a Living Will, MOLST informs medical personnel about a patient's preferences regarding life-sustaining treatments, including resuscitation orders. However, MOLST is a medical order, meaning it is designed for patients with serious health conditions and is respected across all healthcare settings, making it more immediately actionable than a Living Will.

A Health Care Proxy is akin to a Living Will in that it addresses healthcare decisions when an individual cannot make them. However, unlike a Living Will, which provides specific directives about care preferences, a Health Care Proxy designates another person to make healthcare decisions on behalf of the individual. This role encompasses decisions beyond those directly related to life-sustaining treatments, offering a broader scope of decision-making power.

Advance Directives encompass various types of documents, including Living Wills and Health Care Proxies, aimed at guiding medical care when an individual is incapacitated. An Advance Directive is a broader term that can include both the specific treatment preferences and the appointment of a decision-maker. By its nature, it underscores the intention behind a Living Will but provides a more comprehensive framework for end-of-life planning.

The Five Wishes document is an advanced care planning tool that goes beyond the medical focus of a Living Will by addressing personal, emotional, and spiritual needs in addition to medical wishes. It prompts individuals to consider comfort care, living arrangements, and how they want to be remembered, alongside specifying medical treatments they want or do not want. This holistic approach distinguishes it from the more medically focused Living Will.

A Do Not Resuscitate (DNR) Order is a medical order that specifically directs healthcare providers not to perform CPR if a patient's breathing stops or if the heart stops beating. While a Living Will may include directives about not using extraordinary measures to prolong life, a DNR is a legally binding document that applies in all medical situations. It is typically used by individuals with a terminal illness or those in a permanently unconscious state.

The POLST (Physician Orders for Life-Sustaining Treatment) form, similar to MOLST, outlines a patient's wishes regarding medical treatment, including measures to prolong life. Both are designed for seriously ill patients and serve as actionable medical orders rather than general preferences. However, POLST is used more broadly in various states under different names, indicating regional variations in approach to end-of-life care documentation.

An Instruction Directive, often part of an Advance Directive, specifically details the types of medical treatment that an individual wishes to receive or avoid. This directive is similar to a Living Will in that both provide guidance about medical care preferences. However, an Instruction Directive is typically used in conjunction with an Appointment of Healthcare Representative form, which names a decision-maker, thereby combining elements of a Health Care Proxy and a Living Will.

A Financial Power of Attorney is a legal document that, while distinct in purpose, shares the concept of delegation seen in a Living Will. It designates an individual to manage financial affairs on someone's behalf, contrasting with a Living Will's focus on healthcare decisions. Nonetheless, both documents prepare for a time when the principal may be incapacitated, ensuring that important decisions reflect their values and wishes.

Last, the Ethical Will, though not a legal document, is spiritually related to a Living Will. An Ethical Will is designed to pass on values, beliefs, blessings, and advice to future generations, rather than specifying medical wishes or designating decision-making authority. While differing in content and purpose, both documents reflect an individual's desire to communicate their most deeply held convictions at life's end.

Dos and Don'ts

When it comes to filling out the New York Living Will form, it's important to approach the task with attention and precision. This document plays a critical role in ensuring your healthcare wishes are known and respected in the event that you can't communicate them yourself. To assist you in this process, here are some dos and don'ts to keep in mind:

Do's:
  1. Read the form carefully before you start filling it out. Understanding every section will help you accurately express your wishes.
  2. Use clear and precise language to describe your healthcare preferences. Ambiguities can lead to confusion and misinterpretation.
  3. Consult with a healthcare professional if you have any doubts about the medical terms or procedures mentioned in the form. Their insight can help you make informed decisions.
  4. Discuss your wishes with your loved ones and the person you intend to appoint as your healthcare proxy, if applicable. This conversation can help prepare them for future decisions.
  5. Sign and date the form in the presence of two witnesses, who also need to sign it, to ensure its legal validity.
Don'ts:
  1. Don't leave sections blank unless they are explicitly optional. Incomplete information can lead to uncertainties about your intentions.
  2. Don't use terms or phrases that are open to interpretation without providing a clear explanation of what you mean. Specificity is key in a living will.
  3. Don't forget to review and update your living will regularly, especially after significant life events such as marriage, divorce, the birth of a child, or a change in health status.
  4. Don't assume that verbal instructions to family or doctors will be sufficient. A legally documented living will is the best way to ensure your wishes are followed.
  5. Don't hesitate to seek legal advice if you have any questions or concerns about completing the living will form. A legal professional can provide guidance tailored to your specific circumstances.

Misconceptions

In discussing Living Wills, particularly within the state of New York, it's crucial to dispel some common misconceptions. Understanding these aspects can assist individuals in making informed decisions about their healthcare and end-of-life planning.

  • Only for the Elderly: A pervasive misconception is that Living Wills are only relevant for the elderly. However, unexpected medical situations can arise at any age, making a Living Will a wise consideration for adults regardless of their age.

  • Legally Complicated to Create: Many people believe that creating a Living Will is a complex legal process. In reality, New York law provides a straightforward framework for individuals to express their healthcare preferences, often without the need for a lawyer.

  • Not Necessary if You’re Healthy: A common misconception is that Living Wills are unnecessary for those in good health. However, they are precisely to express wishes regarding medical treatment in unexpected situations where one cannot communicate their desires directly.

  • Dictates All Medical Treatments: It's commonly misunderstood that a Living Will dictates all future medical treatments. Rather, it outlines wishes for end-of-life care under specific circumstances, without encompassing all possible medical interventions.

  • Overrides Family’s Wishes: Another misconception is that a Living Will completely overrides any family wishes. While it does provide a legal basis for your healthcare preferences, health care providers often encourage dialogue and consensus among family members regarding end-of-life care.

  • Once Completed, It’s Permanent: Many believe that once a Living Will is signed, it cannot be changed. In reality, individuals can update or revoke their Living Will at any time, reflecting changes in their wishes, health status, or relationships.

  • Expensive to Create: The belief that creating a Living Will is expensive discourages some. In fact, New York allows for Living Wills to be drafted without significant cost, and one may not necessarily need to hire an attorney to create a valid document.

  • Only Covers End-of-Life Decisions: Finally, there's a misconception that Living Wills are exclusively for end-of-life decisions. While they focus significantly on this aspect, they can also specify preferences for other types of medical interventions or non-treatment under certain conditions.

Dispelling these misconceptions about the New York Living Will form is essential. It empowers individuals to take proactive steps in managing their healthcare decisions and ensures their wishes are respected, even when they cannot speak for themselves.

Key takeaways

Filling out a New York Living Will is an important step for ensuring your wishes are respected in terms of healthcare, particularly if you become unable to communicate those wishes. Here are seven key takeaways about this crucial document:

  • Understand what a Living Will is: It's a legal document that records your wishes regarding medical treatment in scenarios where you are unable to make decisions or communicate due to incapacity. This could include decisions about life-sustaining treatments or other end-of-life care considerations.

  • Know the requirements: In New York, for a Living Will to be considered valid, it must clearly articulate your treatment preferences and be signed by you. Witnesses or notarization might be required, so it's advisable to check the most current legal requirements or consult with an attorney.

  • Be specific: Clarity is key in a Living Will. The more specific you are about your medical treatment preferences, the easier it will be for your healthcare providers and loved ones to follow your wishes. Include instructions on the use of life-sustaining measures such as artificial hydration, nutrition, ventilators, and do-not-resuscitate (DNR) orders.

  • Choose a healthcare proxy: While the Living Will speaks to your treatment preferences, appointing a healthcare proxy (or agent) who can make decisions on your behalf if you're unable to can ensure that your healthcare wishes are respected and implemented. This selection should be documented, typically in a separate but related document known as a Healthcare Power of Attorney.

  • Review and update regularly: Your preferences for medical treatment may change over time. It is wise to review and potentially update your Living Will periodically, particularly after significant life events such as a diagnosis of a serious illness, marriage, divorce, or the birth of a child.

  • Distribute copies to the right people: Once your Living Will is finalized, ensure your healthcare proxy, family members, and healthcare providers have copies. This guarantees that those responsible for your care are aware of your wishes and can access your Living Will when needed.

  • Know it complements your medical records: A Living Will becomes a part of your medical records, so it's accessible to healthcare providers when making critical treatment decisions. Ensuring it is readily available in medical settings, such as hospitals or nursing homes, can be crucial in emergencies.

By taking these key points into consideration, you can create a Living Will that effectively communicates your healthcare wishes, providing peace of mind for you and your loved ones.

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