The living will explained

A living will is a document in which you record which medical procedures you consent to and which you do not, in the event that you are no longer mentally capable. You can also designate someone to make decisions on your behalf.

In this context, “no longer mentally capable” means you have lost the capacity to understand the meaning and consequences of medical decisions and to act accordingly. This may be the case, for example, following an accident, a serious illness or advanced dementia.

As a general rule, doctors and nursing staff must comply with a living will as it is a legally binding document. However, this only applies if the treatments it describes are medically feasible and permitted by law. In an emergency, medical personnel must check that a living will still corresponds to the current wishes of the person concerned. If there are legitimate doubts, for example because their circumstances have changed significantly or the living will is very old, it may no longer be legally valid.

Our partner, the Swiss Red Cross (SRC), provides a free template for a living will form to download as well as detailed guidance on the form. These documents will help you understand the issues and provide a sound basis for your decisions.

Anyone with mental capacity can write a living will. Does the living will have to be handwritten? Not necessarily; in Switzerland, you can create the document by hand or digitally. The important thing is that you date the living will and sign it by hand. In certain situations, such as the onset of dementia, it can be helpful to have your mental capacity confirmed by a specialist. Does a living will also need to be certified? No, the document is still valid without notarisation.

However, it is a good idea to seek advice when you draw up a living will. Remember, this document covers complex medical and legal questions. You can get professional advice from the SRC, for example. The SRC’s trained advisors will help you reflect on your values and provide expert support as you complete the living will. Is your situation highly complicated? For example, do you have a severe or chronic illness? If so, include your attending physician in the process.

In principle, a living will is valid indefinitely. Nevertheless, it makes sense to review it regularly and update it if necessary. Even if nothing has changed, it is still a good idea to date and sign the living will again. This makes it easier to determine whether the will still corresponds to your current wishes in the event of an emergency. You can amend or revoke your living will at any time. Always destroy older versions to prevent misunderstanding.

In Switzerland, a simple living will should contain the following information at a minimum:

• Your personal details
• Your GP’s details
• Authorised representative and, if necessary, their substitute
• Personal values
• Resuscitation measures in the event of cardiac arrest
• Objective of treatment where there is a low chance of recovery
• Scope of the living will
• Date and signature

The SRC form has a second module. This is voluntary and contains additional medical instructions on scenarios such as tube feeding, artificial respiration and organ donation.

Even the best living will doesn’t cover every situation. However, a clearly formulated set of values helps the treatment team and the authorised representative understand and act on your presumed intentions.

Store the original of your living will at home where it is easy to find. Give a copy to your authorised representative and to your GP. Carry an information card in your wallet stating where the living will can be found and who should be contacted in an emergency. You can also have the existence of a living will registered on your health insurance card.

You can lodge your living will with the SRC as well. You will then receive a personal ID with an emergency number that you can store in your wallet. In an emergency, the medical treatment team can use this number to access your living will at any time.

Living wills only apply if a person who has lost mental capacity requires medical treatment. If you don’t have a living will, the law says the following people are to make decisions, in the order shown:

1. Spouse or registered partner
2. People living in the same household
3. Descendants
4. Parents
5. Siblings

These must be individuals who provide regular, personal support to the person concerned. Sharing a home is not enough in itself. If there is no one suitable or available, the Child and Adult Protection Authority (CAPA) will appoint an advisor. However, this may take some time.

In a sudden emergency, there may not be enough time to clarify whether you have a living will. In these situations, doctors will first of all do everything they can to save your life. Once they know you have a living will, they will factor it in to further treatment.

By drawing up a living will, you are setting out your wishes regarding medical intervention in advance. A living will provides clarity for doctors and family members if you are no longer mentally capable. It also reduces uncertainty in the event of an emergency and eases the pressure on those around you. So it’s important to think about your values and wishes in good time. This will ensure that they are respected and that you receive the best support.