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Living wills on the coronavirus test bench

In a written living will you can specify, as a precaution, the medical interventions that should or should not be carried out in the event that you are no longer able to communicate because of an accident or an illness. In these coronavirus times, the question that arises is whether specific living wills have to be drafted to cover the treatment associated with succumbing to the SARS-CoV-2 virus or whether existing living wills have to be updated in order to reflect the reality of such treatment.

Typical cases where a living will be consulted

A living will is generally drafted for cases where a patient is irreversibly unconscious, has suffered permanent brain damage, or in all probability has become terminally ill. Since the patient will not be able to communicate any more in the above-mentioned situations, the living will can determine, for example, if life-sustaining or life-prolonging measures are desired, such as resuscitation, ventilation, organ transplants, dialysis, blood transfusion, drug administration or artificial feeding.

Temporary artificial ventilation in the case of COVID-19

Temporary artificial ventilation in the case of a COVID-19 infection is not covered by the typical cases where a living will would be consulted because the goal of the treatment is to completely eliminate the lung infection. Even severe cases would thus not initially be regarded as terminal illnesses. Furthermore, in most cases, patients would still be able to communicate and, beforehand, consent to ventilation and being put into a medically induced coma.

The risk of longer-lasting artificial ventilation in the case of COVID-19

The risks that result from an existing living will could then arise if the treatment is not effective or has to be continued for longer than usual. In such a case, if the physicians are of the view that a cure or regaining consciousness is unlikely then the provisions in a living will that was drafted before the time of COVID-19 may apply. If, in the living will, the patient has specified that s/he would not wish to have life-prolonging ICU measures, or only for a certain period then the treatment may be discontinued.

Specific patient provision for a case of COVID-19

Existing living wills should be adapted to take account of the current situation of a COVID-19 infection that requires treatment. In addition to amending an existing living will, there is also the option of drafting a separate living will for a case of COVID-19. In this connection, it should also be specified if experimental doses of new drugs or those that have not been approved for the treatment of COVID-19 would or would not be desired.

Creation and effects of a living will

Living wills can be privately recorded in writing. Moreover, many institutions provide templates. Ideally, you should first talk to a physician and get help from a lawyer because living wills should contain sufficiently specific requirements in order to be legally effective.

Besides creating a living will, you should also give a particular person who you trust power of attorney for health care. The person who acts as the attorney would then be able to ensure that the wishes laid down in the living by the patient are fully respected in the decisive case.

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