The living will - a helpful tool for communication and decision-making regarding death and dying

The concept of 'living will', also known as 'advanced directive', emerged in response to modern medical technologies and aggressive medical treatments being implemented in ambiguous situations such as a poor prognostic state. A living will aims at protecting the patient's right to autonomy in such a situation. Ideally, it is a substitute for the actual informed consent or refusal in situations where the individual is unable to express his or her will due to incapacity. At least, a living will can usefully inform medical-ethical decision-making on behalf of an incompetent patient. A living will can either be very general or very specific. It may hold specific directives about the use or foregoing of potentially burdensome medical treatments including food and water to be supplied by feeding tubes or other medical devices. In addition of being a helpful tool for respecting a patient's autonomy, a living will may be regarded as an opportunity for improving communication about death and dying with patients and healthy people alike.