A while back, a mutual friend of the Bitches unexpectedly found herself in the ICU. She was very young, very healthy, and due to be wed to her deeply devoted partner within weeks. She was unconscious and totally incapacitated, and needed someone to make healthcare decisions on her behalf.
The funny thing about engagements is that they aren’t legally binding. So even though her fiancé absolutely knew her wishes better than anyone, all medical decisions reverted to her mother. I should say: the alcoholic, emotionally abusive mother she’d moved thousands of miles to escape from.
Maybe you’re one of those lucky people with a spouse, or living parents, who understand and agree with your decisions 100% of the time. But maybe you’re like our friend above, and your default healthcare advocate is dangerous, untrustworthy, or completely out-of-touch with your wishes and values. Failing to plan for unforeseeable medical emergencies can put your body and your life into the hands of someone who you don’t trust. And that is a very, very scary situation.
“Can we perform this risky surgery to preserve his cognitive functioning? Can we abort the fetus to save her life? Should we amputate this limb to give her a better chance at a full recovery? How long would he want to be kept alive by machines and feeding tubes? Who does she want her children to go to?”
These are the kinds of questions someone may need to answer one day—about you. And of all the billions of people on the planet, there are exactly three people I would trust to referee this shit for me. None of them were designated to do so for the first quarter century of my life. So it’s a good thing that bus never hit me.
In the event of a catastrophe, do you want your extra-religious parents to get a say in how long you can be kept on life support? Do you want your abusive soon-to-be-ex spouse to get full custody of your children? Do you want your homophobic family members to have the ability to lock your partner out of your finances? Do you want your children taking each other to court for a disagreement over what to do with body?
…Yeah, I thought not.
Our most essential human freedom is the right to control our own bodies, and have our decisions regarding them respected. The best way to ensure that happens is to have your wishes written down in a legal document and to make sure that document can be found in a crisis.
Cost: Free through TotalLegal
If you are not able to express informed consent to medical procedures, a living will (also known as a healthcare directive or an advance directive) speaks for you. It covers some of the most sensitive and controversial areas of medicine, like resuscitation, mechanical ventilation, tube feeding, palliative care, and organ donation.
Even if you think you know what you want, a good living will will draw out unlikely situations that nevertheless deserve thought. For example, I chose to decline ventilators and feeding tubes if I am ill or injured to such an extent that meaningful recovery is impossible. “Cool, cool,” replied my living will, “but what if you’re pregnant at the time and the fetus isn’t yet viable?”
… Oh. Wow. I wouldn’t have thought of that.
Serious injury, illness, and death sometimes come on slowly, and sometimes suddenly. If you are incapacitated and unable to make choices for yourself, you want your wishes and limitations respected, period. A living will allows you to do that.
Best of all, it’s offered completely free. TotalLegal offers a complimentary customized living will. It asks you plain English questions about your wishes, then spits out a legally compliant document tailored to your state’s allowances and regulations. That is an amazing service. Take advantage of it NOW. A ten-minute investment may save you and your loved ones from confusion, disagreement, and anguish.
(Ain’t you ever read My Sister’s Keeper? Disagreements about this shit tears families apart. Don’t let the lunatics you’re related to play guess-and-check with your half-dead body!)
Medical power of attorney
Cost: $20 through TotalLegal
Medical power of attorney, also known as the appointment of a healthcare proxy, is what would’ve saved our buddy in the above story a lot of heartache. It names someone that you trust to act as a decision-maker on healthcare issues. The living will covers broad attitudes and expectations; a healthcare proxy will be the person your doctors go to at each step of your treatment. The two documents, working in concert, give you the best possible chance to see your wishes enacted.
Before you list someone as your healthcare proxy, sit down with them and have a long and honest talk about your expectations. Don’t just default to your parents or your spouse; take the time to establish that this person is a good fit for you. If you are an atheist who wants no extraordinary lifesaving measures taken and would donate your own body to science, maybe don’t ask your father, a devout Catholic, who’d like to see you kept alive by any means necessary and would bury you in the family plot behind the church after an open-casket funeral.
Last will and testament
Cost: $20 through TotalLegal
I actually think this one is the least important, because it mostly just covers your money and your junk. But Money N’ Junk was our second choice for the title of this blog.
Your last will and testament dictates what will happen to your estate—your money, your property, your minor children, and even your pets. You can designate one person (along with a backup or two) to be your executor. This is the person who handles the administrative tasks of distributing the estate on the terms set forth in your will, not the person who receives the money. That person is your beneficiary (or beneficiaries). The executor is not usually paid unless you make a special note to set aside a gift for them in exchange for their hard work. (Nudge nudge, do it! Estate management is hard work!)
The simplest way to divvy up your estate (and the method that requires less frequent updating) is to leave the division up to a trusted person who knows your heart. This person must be rock solid in their trustworthiness, and such people are rare—it’s probably your spouse or nobody. Another easy way is to divide everything equally among heirs, and don’t waste time divvying up individual items or properties.
(Many will preparers will warn you that nasty feuds can start between family members and other heirs over things like heirlooms, antiques, jewelry, cars, and houses. They will advise you to avoid any confusion by listing those items out explicitly so that there can be no arguing. HOWEVER I say those people are garbage people and deserve whatever miserable sniping and legal wrangling they see fit to begin. I call this a VVitch VVill! Think of it as a curse upon the petty people left behind. It’s a way to make your money work for you, even after death.)
What to do with them once you have them
Once you have your documents, email a copy to each of the people mentioned within them. Make the subject line easily searchable for future emergencies.
For medical directives, send a copy to your doctor and ask him or her to include them with your medical records.
Finally, print a copy and keep it in a clearly-marked folder with all your other important paperwork. Make a point of telling multiple people where these documents exist, especially if they live with you: your roommate, your best friend, your family members, your significant other or spouse. Don’t make people dig through your shit like it’s Hoarders.
A final (ha ha!) note on the price of end-of-life documents
There’s a reason all my recommendations are for TotalLegal. It’s not because they’ve given me money. ALTHOUGH THEY SHOULD. I HAVE GUINEA PIGS TO FEED.
Many websites will offer you “free” legal paperwork. And after filling out a lengthy questionnaire, you’re prompted to sign up for a monthly recurring “legal service on demand” to get your “free” documents. Don’t waste your day getting baited, switched, and scammed. Pick one affordable provider who is up-front about their prices (and doesn’t try to package it as a monthly service, a truly ridiculous premise). Just drop $40 and rest easy that it’s been done right.