Living Will vs Power of Attorney: Understand What You Need

It’s rarely appealing to consider how we want our treatment to proceed if we’re ever unable to decide for ourselves. And yet, expressing your wishes on the right form ensures that, if a moment comes, your choices are legally protected and your family isn’t left guessing. You probably hear these terms often: A Living Will and a Medical Power of Attorney. Do you need both of them, or just one, and do they have any hierarchy? This article explains the difference between a living will and a power of attorney, what happens if you use them together, and how they work in real life. 

A living will states your medical treatment preferences. It is an advance directive that outlines your choices of how you want to be medically treated if you cannot communicate for yourself (e.g., long-term unconsciousness, etc). It guides your healthcare providers through high-stakes medical decisions and in specific medical conditions, such as whether to proceed with life-sustaining treatment, while respecting your personal autonomy and right to decide for yourself. A medical professional must act in accordance with the living will, provided they are aware of its existence. 

A Power of Attorney is a document that authorizes a trusted person to make decisions for you in real time. A Medical Power of Attorney establishes a new legal relationship and appoints your healthcare agent. You do not lose your right to make decisions when you sign a POA. This document just allows your agent to act in your interests when you’re not there to make these decisions, e.g., while you’re abroad or undergoing surgery. 

There are different types of Power of Attorney that give your agent varying levels of authority based on what you need. 

Do you need to get a Living Will or a Medical Power of Attorney? These two differ in scope, timing, and the authority you give to the other person.

A Living Will is far more limited. It is used in end-of-life choices and/or severe medical conditions. However, it isn’t used to manage routine healthcare choices and decisions. It can be used to enforce after-life decisions, such as organ donation, even against your family’s wishes, or refuse treatment.

An MPOA is much more flexible and grants your agent the right to decide a lot of factors related to your health. Your agent can choose which hospital you stay in, access your medical records, and hire or fire specific doctors. 

Both documents have entirely different triggers that put them in action.

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Although you can use just one of these documents, they can work together and provide you with the strongest protection.

While doctors are legally obliged to follow your living will, medical situations are rarely that black-and-white. If your living will states that a person doesn’t want “unreasonable life support,” doctors will still need to decide what “unreasonable” means. In this case, a person with a MPOA can step in to interpret a living will and advocate for the patient’s comfort. 

Let’s try a hypothetical case. Imagine you are injured in a severe car accident and experience temporary brain trauma. Your living will might state that you don’t want doctors to put you on permanent life-support machines if your condition is irreversible. But because your condition might improve with short-term treatment, doctors aren’t sure how to act. 

If you have an MPOA, your agent can speak with the medical team, look at the prognosis, and make a decision. It’s an adaptation that considers initial expectations and accounts for new variables. By combining a living will and an MPOA, you have double protection that will ensure your dignity and life are respected.

Situations in which a Living Will and an MPOA conflict do happen, though they are relatively rare. Typically, because they activate in rather different medical situations and points, they don’t contradict each other. But if such a situation occurs, every state has its own regulations (or some do not regulate that at all). To simplify this process, many states allow you to combine both instruments into an Advance Directive, which is considered with all decisions regarding your treatment and end-of-life care. An advance healthcare directive may combine living will and medical power of attorney. After consulting your state laws, you can use this form to ensure everything is in order. 

In the end, both a Living Will and an MPOA have their pros and cons, and they are applicable in entirely different conditions.