Making a living will involves a deep and reflective process that forces people to face their values, beliefs, and preferences for medical care and end-of-life care. As a hypothetical 26-year-old, Sylvia McKinney’s living will serve as a testament to the importance of considering future planning and the dynamic nature of life. This paper examines the complexities of my living will, examining my choices’ ethical, practical, and personal implications and placing them in more significant debates in bioethics and medicine.
In the initial part of her living will, Sylvia tends to acknowledge my current financial status as being without assets or substantial funds. This upfront openness creates the foundation for a document that is dynamic and flexible enough to change with my circumstances should they arise. My ability to see ahead and recognize that changes may be necessary in the future shows that I am conscious of how life, finances, and priorities change. In Sylvia McKinney’s living will, there is an explicit acknowledgment of the current financial situation. From the text, Sylvia states, “I, at my ripe age of 26, currently have no assets or significant finances that would warrant putting in writing what I would and who I would give said nonexistent things at this time” (p.1). This declaration clarifies Sylvia’s current financial situation by emphasizing the lack of significant assets or savings. But Sylvia also shows foresight by acknowledging that her financial circumstances might change. Sylvia states, “But should I come into a greater financial situation, or acquire a multitude of assets, I will be sure to amend this Living Will and go from there, in terms of what, and who I would give, insert imaginary, finances and assets at this time” (p.1).
This statement reflects a recognition that financial circumstances can evolve, and Sylvia is open to revising her living will to align with any changes in her financial status. According to Blackwood et al. (2019), financial considerations can play a significant role in healthcare decision-making, and individuals may be encouraged to address these aspects in their advance directives to provide clarity for their loved ones and appointed decision-makers. While the living will provided does not delve deeply into Sylvia’s financial worries beyond her current lack of significant assets, scholars such as Blackwood et al. (2019) and Gudat et al. (2019) address the need for further research on the broader societal context in which financial considerations often intersect with healthcare planning. Gudat et al. (2019) state that financial stability or instability can influence an individual’s access to healthcare resources, choices regarding medical treatments, and the ability to plan for end-of-life care in a way that aligns with their values and preferences.
The Health Care Directive section of my living will serve as a cornerstone, expressing my desires for medical treatment and life-sustaining measures when I cannot communicate my wishes. This section not only underscores my autonomy but also deeply contemplates the quality of life versus the lengths to which medical interventions should be pursued. My preference for palliative care, despite the potential acceleration of death, aligns with a growing recognition in healthcare of the importance of ensuring comfort and dignity in the final stages of life. Akdeniz et al.(2021) and Blackwood et al. (2019) emphasize the importance of autonomy in healthcare decisions, including those outlined in living wills. Using the first person to express preferences, as seen in the text, as Sylvia states, “I cannot communicate my wishes,” aligns with the ethical principle of respecting an individual’s autonomy (Blackwood et al. 2019).
The process of filling out an advanced directive, such as a living will, is a deeply personal and contemplative experience. The gravity of these decisions necessitated careful introspection, forcing me to grapple with my values, beliefs, and priorities concerning health and well-being (Akdeniz et al., 2021; Gudat et al., 2019). In particular, the Health Care Directive section became a focal point of this self-reflective process. Expressing my desires for medical treatment and life-sustaining measures during a time when I might be unable to communicate my wishes demanded a level of clarity and specificity that went beyond mere theoretical considerations. Therefore, there is a need to envision potential scenarios and make decisions about how much I would want medical interventions to prolong life. Sylvia’s designation of her oldest living child or the most responsible relative as the executor of her wishes adds a familial and personal touch to her living will. The qualities she lists for this person—financial responsibility, family orientation, and a stable relationship—emphasize trust and dependability when making such delicate choices. This section of the document discusses end-of-life care’s relational and emotional aspects, emphasizing the importance of assigning a caregiver who is deeply acquainted with the patient’s values and preferences. Contemplating the quality of life versus the lengths to which medical interventions should be pursued became a poignant exercise. The preference for palliative care emerges from a desire for comfort and dignity (Akdeniz et al., 2021), and this choice may require me to confront my own perceptions of a meaningful and fulfilling existence, even in the face of terminal conditions.
The explicit details regarding life-sustaining treatment and organ and tissue donation showcase Sylvia’s informed decision-making process. Her clear refusal of certain forms of life support and organ donation indicates a desire for a natural progression of life and a reluctance to prolong suffering through medical interventions. This decision is not only a personal choice but also echoes broader debates in bioethics about the balance between autonomy, beneficence, and the sanctity of life (Blackwood et al., 2019). One important aspect of Sylvia’s living will is the designation of a healthcare agent. Sylvia trusts a person she has a solid emotional bond with by choosing her fiancé, Kirk Mayer, for this position. I would also make this choice in my will as it demonstrates the importance of empathy and understanding in navigating difficult medical decisions by illuminating the connection between interpersonal relationships and healthcare decisions. Sylvia’s thought of Allissa Franklin as a backup healthcare agent emphasizes the value of having backup plans because unanticipated events can happen.
In the General Provisions section, Sylvia explicitly states that this living will is the only one she has made at its creation. This clarity is crucial to avoid conflicts arising from multiple or conflicting directives. I have also learned that when filling in my will, filling out an advanced directive involves an awareness of legal and formal requirements. This may include considerations such as notarization, witnessing, and compliance with regional regulations; understanding these requirements ensures the validity and enforceability of the document (Gudat et al., 2019). Sylvia’s awareness of the legal requirements, such as notarization and witnesses, and her commitment to fulfilling these when necessary highlight a meticulous approach to ensuring the validity and enforceability of her living will. I should also consider the multi-layered approach to appointing health care agents, including a primary agent, an alternate, and a provision for an alternative to the alternate, as used in the text, which demonstrates Sylvia’s foresight and commitment to ensuring that her wishes are honored, even in the face of unforeseen challenges. This layered approach reflects a nuanced understanding of the unpredictable nature of life and the need for flexibility in decision-making.
Conclusively, creating a living will is a deeply personal and reflective process that demands individuals confront their values and beliefs regarding medical treatment and end-of-life care. Sylvia McKinney’s hypothetical living will serve as a comprehensive example of a document that is not only informed by personal values but also attuned to the broader ethical considerations in healthcare. From her transparent acknowledgment of her current circumstances to the meticulous selection of healthcare agents, Sylvia’s living will is a testament to the complexity and depth of end-of-life decision-making. This process, influenced by class and scholarly work concepts, reflects a broader societal shift toward patient-centered care and a nuanced understanding of the ethical dimensions of healthcare decision-making.
References
Blackwood, D. H., Walker, D., Mythen, M. G., Taylor, R. M., & Vindrola‐Padros, C. (2019). Barriers to advance care planning with patients as perceived by nurses and other healthcare professionals: A systematic review. Journal of Clinical Nursing, 28(23-24), pp. 4276–4297.
Akdeniz, M., Yardımcı, B., & Kavukcu, E. (2021). Ethical considerations at end-of-life care. SAGE open medicine, 9, 20503121211000918.
Gudat, H., Ohnsorge, K., Streeck, N., & Rehmann‐Sutter, C. (2019). How palliative care patients’ feelings of being a burden to others can motivate a wish to die. Moral challenges in clinics and families. Bioethics, 33(4), 421-430.
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