Printable  Living Will Form for Wisconsin Open Editor Here

Printable Living Will Form for Wisconsin

A Wisconsin Living Will form is a legal document that allows individuals to outline their preferences for medical treatment in the event that they become unable to communicate their wishes due to a serious health condition. It serves as a guide for healthcare providers and family members, ensuring that the care received aligns with the person's values and desires. This document plays a crucial role in end-of-life planning, giving people a voice in their treatment when they may not be able to speak for themselves.

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Content Overview

In the context of modern healthcare, the importance of planning for the future cannot be overstated, particularly when it involves decisions around end-of-life care. A key instrument for such planning in Wisconsin is the Living Will form, a legal document that allows individuals to outline their preferences for medical treatment in the event they are unable to communicate their wishes due to incapacity. This document serves as a guide for healthcare providers and loved ones, ensuring that the individual's desires are respected, even when they can no longer voice them. The form covers various aspects of care, including the acceptance or refusal of life-sustaining measures and the use of feeding tubes. It only becomes operative under specific medical conditions, as defined by state law, requiring the individual to be in a terminal condition or in a persistent vegetative state for the directives to take effect. The process of completing a Living Will is governed by legal requirements, including witnessing and notarization, to ensure the document's validity and enforceability. As such, the Wisconsin Living Will is a powerful tool for personal autonomy, enabling individuals to control their medical care and relieve their loved ones from making these difficult decisions during emotional times.

Sample - Wisconsin Living Will Form

Wisconsin Living Will Template

This document serves as a Living Will, designed in accordance with the Wisconsin Statutes, specifically the provisions under the Wisconsin Declarations to Physicians Act (Wis. Stat. § 154.03). It is a legally binding document that outlines your personal wishes regarding medical treatment in the event you are no longer able to communicate or make decisions due to incapacity.

Please fill in the blanks with the required information to complete your Wisconsin Living Will:

Name: ____________________________

Date of Birth: ____________________________

Address: ____________________________

City: ______________________ State: WI Zip Code: ___________

Primary Physician: ____________________________

Primary Physician's Contact Information: ____________________________

Living Will Declarations

As the declarant, I wish to make it known that my directives as stated herein should be followed in the event that I become persistently unconscious, am in the final stage of a terminal illness, or am otherwise unable to communicate my health care preferences due to any incapacity.

Life-Sustaining Treatment

___ I wish to receive life-sustaining treatment that has the potential to prolong my life, except in cases where the treatment would only prolong the process of dying, would be ineffective in improving my condition, or would otherwise be contrary to my personal values and beliefs.

___ I do not wish to receive life-sustaining treatments under any circumstances that would merely prolong the moment of my death, are unlikely to restore me to meaningful interaction with my environment and loved ones, or are contrary to my fundamental values and beliefs.

Nutrition and Hydration

___ I wish to receive artificially provided nutrition and hydration, regardless of my condition or prognosis.

___ I do not wish to receive artificially provided nutrition and hydration if the burdens of such treatment outweigh the benefits or if my condition is terminal and such measures would only prolong the dying process.

Signature and Witnesses

My signature below indicates that I understand the contents of this document and that I wish to direct my medical care according to the terms stated herein.

Signature: ____________________________ Date: ____________________________

Witness #1 Signature: ____________________________ Date: ____________________________

Witness #1 Print Name: ____________________________

Witness #2 Signature: ____________________________ Date: ____________________________

Witness #2 Print Name: ____________________________

It is recommended that witnesses be individuals who are not related to you by blood or marriage and who would not be entitled to any portion of your estate.

Document Attributes

Fact Number Fact Detail
1 Wisconsin's living will is officially referred to as a "Declaration to Physicians".
2 This form allows individuals to outline their wishes regarding life-sustaining medical treatment in the event they are incapacitated and cannot communicate.
3 It is governed by Chapter 154 of the Wisconsin Statutes.
4 To be valid, the living will must be signed by the declarant and two witnesses.
5 Witnesses cannot be the health care provider or an employee of the health care provider, nor can they be a relative by blood, marriage, or adoption.
6 The form only comes into effect under specific medical conditions, such as a terminal illness or permanent unconsciousness, as certified by two physicians.
7 The declarant can specify whether they want to receive, withhold, or withdraw life-sustaining measures and feeding tubes.
8 Any competent individual 18 years of age or older can execute a living will in Wisconsin.
9 A living will can be revoked at any time by the declarant through a written or oral statement, or by destruction of the document.
10 Health care providers in Wisconsin are legally bound to follow the instructions laid out in a properly executed living will, provided they have actual knowledge of its existence.

Guidelines on Utilizing Wisconsin Living Will

Completing a Wisconsin Living Will is a thoughtful step towards making one’s healthcare preferences known in situations where they might not be able to communicate their wishes themselves. This legally binding document helps ensure that an individual's decisions regarding life-sustaining treatment are respected, even when they are unable to express those decisions due to illness or incapacity. To complete this form accurately, it's important to follow the steps outlined below, which are designed to make the process as straightforward as possible. Careful attention to each step will ensure that the form reflects the individual's true healthcare preferences.

  1. Begin by reading the entire form to ensure a clear understanding of what is being requested in each section. This preliminary review will help in gathering the necessary information before filling it out.
  2. Enter your full name, date of birth, and address at the top of the form to establish your identity.
  3. Specify the circumstances under which you would want to refuse life-sustaining treatment. Be as clear and detailed as possible to avoid any ambiguity regarding your wishes.
  4. If applicable, indicate your preferences regarding the use of feeding tubes for nutrition and hydration. Remember, this is a deeply personal decision that requires thoughtful consideration.
  5. Appoint a health care agent by including the name, relationship, address, and contact information of the person you trust to make health care decisions on your behalf, should you become unable to communicate your wishes directly.
  6. Review the section regarding organ and tissue donation, if you choose to include directions about donation. Specify any limitations or specific instructions you have concerning donation.
  7. Sign and date the form in the presence of two witnesses. According to Wisconsin law, these witnesses cannot be individuals who are directly involved in your healthcare, related to you by blood, marriage, or adoption, or who stand to inherit from your estate.
  8. Have the witnesses sign and date the form, confirming they have witnessed you signing the document and acknowledging your signature as voluntary and under no undue influence.

Once the Living Will form has been fully completed and witnessed, it's important to share a copy with your healthcare provider and a trusted family member or friend. Keeping the original document in a safe but accessible place, and letting others know where it can be found, will ensure your wishes are honored. Remember, this document can be revised or revoked at any time, should your healthcare preferences change. It reflects your wishes at the time it is signed and witnessed and plays a crucial role in your healthcare planning.

Listed Questions and Answers

What is a Living Will form in Wisconsin?

A Living Will form in Wisconsin, legally known as a "Declaration to Physicians" or a "Wisconsin Directive to Physicians," is a legal document that allows individuals to outline their preferences for medical treatment in situations where they are no longer able to make decisions due to incapacitation. This document specifically addresses scenarios involving terminal illness or permanent unconsciousness.

Who should have a Living Will in Wisconsin?

Any person over the age of 18 who wishes to have control over their medical treatment in the event they become incapacitated should consider creating a Living Will. It provides a way to communicate your health care preferences to family members and medical professionals, ensuring your wishes are followed.

How does one create a Living Will in Wisconsin?

To create a Living Will in Wisconsin, an individual must complete the Directive to Physicians form. This includes specifying what types of life-sustaining treatments should or should not be administered if they are in a terminal condition or in a state of permanent unconsciousness. The form must be signed in the presence of two witnesses who are not directly financially responsible for the individual’s health care.

Is a lawyer required to complete a Living Will in Wisconsin?

No, a lawyer is not required to complete a Living Will in Wisconsin. However, consulting with a lawyer can be beneficial to ensure that the document accurately reflects your wishes and meets all legal requirements.

What should be included in a Wisconsin Living Will?

A Wisconsin Living Will should include clear directives about the use of life-sustaining measures, including treatments you would want or not want in cases of terminal illness or permanent unconsciousness. Additionally, it should state your preference regarding feeding tubes and other forms of artificial nutrition and hydration, information about organ donation, and your choice of a health care agent, if applicable.

Can a Living Will be changed or revoked in Wisconsin?

Yes, a Living Will in Wisconsin can be changed or revoked at any time by the creator as long as they are still competent. This can be done by creating a new Living Will, making a written revocation, or verbally expressing the intent to revoke the document in the presence of witnesses.

What happens if someone does not have a Living Will in Wisconsin?

If someone in Wisconsin does not have a Living Will and becomes incapacitated, decisions about their medical treatment will be made by a health care surrogate, who could be a family member or court-appointed guardian. This may result in decisions that are not in line with the individual's preferences or beliefs.

Is a Living Will the same as a Durable Power of Attorney for Health Care in Wisconsin?

No, a Living Will is not the same as a Durable Power of Attorney for Health Care in Wisconsin. A Living Will provides specific instructions about medical treatment preferences, while a Durable Power of Attorney for Health Care appoints someone else, known as a health care agent, to make decisions about your health care if you are unable to do so.

Where should a Wisconsin Living Will be stored?

A Wisconsin Living Will should be stored in a safe place that is easily accessible to your family members or health care agent. Copies should be provided to your physician, health care agent (if designated), and close family members to ensure your wishes are known and respected.

Common mistakes

Filling out a Wisconsin Living Will form is a crucial step for many individuals seeking to ensure their healthcare preferences are honored, especially when they can no longer communicate their wishes due to serious health conditions. However, the process can be delicate and prone to errors. Being aware of the common mistakes can help in creating a clear and effectively crafted document.

  1. Not reading the instructions carefully: Many individuals jump straight into filling out the form without thoroughly reading the instructions. This oversight can lead to misunderstandings about what is required, potentially making the form invalid or not reflective of the individual's true wishes.

  2. Failing to specify detailed healthcare preferences: Some people provide only vague instructions, assuming that their families or healthcare providers will know what to do. It’s crucial to be as detailed as possible about treatments you do or do not want.

  3. Using unclear language: The Living Will should be written in clear, straightforward language. Avoid using complex legal terms or ambiguous phrases that could be open to interpretation.

  4. Not updating the form: Health preferences can change over time. Failing to update your Living Will to reflect these changes can result in a document that no longer represents your current wishes.

  5. Forgetting to sign and date the form: An unsigned or undated Living Will is not legally binding. Ensuring the document is properly signed in the presence of the required witnesses or a notary is crucial.

  6. Not informing family members or healthcare providers: Completing a Living Will and then not sharing it with anyone defeats its purpose. It’s important that family members and healthcare providers are aware of and have access to your Living Will.

  7. Selecting the wrong witnesses: Wisconsin law may have specific requirements regarding who can act as a witness to the signing of a Living Will. Choosing someone who does not meet these criteria can invalidate the document.

  8. Relying solely on a Living Will: While a Living Will is important, it is also wise to have other healthcare directives in place, such as a Durable Power of Attorney for Healthcare. This ensures that someone you trust can make decisions on your behalf should the Living Will not address every situation.

When completing the Wisconsin Living Will form, taking the time to avoid these common mistakes is vital. Ensuring clarity, compliance with legal requirements, and regular updates will help make your Living Will a robust document that safeguards your healthcare wishes. Remember, the goal is to provide peace of mind for both you and your loved ones, making tough decisions a little easier during challenging times.

Documents used along the form

When preparing a Living Will in Wisconsin, individuals often consider several other forms and documents to ensure their healthcare desires and estate plans are fully documented and honored. Here is a list of common documents that are usually prepared in conjunction with a Living Will.

  • Durable Power of Attorney for Health Care: This form allows an individual to appoint someone else to make health care decisions on their behalf if they are unable to make those decisions themselves.
  • Do Not Resuscitate (DNR) Order: A document that instructs healthcare providers not to perform CPR if a person's breathing stops or if their heart stops beating.
  • Declaration to Physicians (Wisconsin Living Will): This form is the actual Living Will itself, indicating a person's wishes regarding life-sustaining measures if they are incapacitated.
  • Power of Attorney for Finances and Property: This document gives someone authority to manage financial and property matters for another person, potentially necessary in cases where health issues cause incapacity.
  • Last Will and Testament: A legal document that lays out how a person's property and affairs should be handled after they die.
  • Organ and Tissue Donation Form: Allows individuals to specify their wishes regarding organ and tissue donation upon death.
  • Funeral Planning Declaration: This form lets individuals specify their preferences for funeral arrangements and provides guidance to loved ones.

Preparing these documents in advance is a thoughtful and responsible way to ensure that an individual's health care choices and estate matters are clearly communicated and legally documented. Together, they provide a comprehensive approach to end-of-life planning.

Similar forms

The Wisconsin Living Will, known formally as a Declaration to Physicians, shares similarities with several other key documents designed to prepare for future healthcare decisions. One such document is the Health Care Power of Attorney (HCPOA). Both empower individuals to make proactive decisions about their healthcare. The HCPOA, however, goes a step further by appointing another person, a trusted agent, to make healthcare decisions on behalf of the individual if they are no longer able to communicate their wishes. This distinction is crucial; while a living will declares specific wishes about life-sustaining treatments, the HCPOA designates an advocate to speak and make decisions across a broader range of medical situations.

Another document related to the Living Will is the Do Not Resuscitate (DNR) Order. Both documents are directed at end-of-life care choices, but their scopes and applications differ significantly. A Living Will provides instructions regarding the use or non-use of life-sustaining measures in the event of a terminal illness or a persistent vegetative state. In contrast, a DNR specifically instructs healthcare providers not to perform cardiopulmonary resuscitation (CPR) if a person’s breathing or heartbeat stops. The DNR is more narrowly focused and is immediately actionable in emergency situations, whereas a Living Will addresses a broader range of scenarios and treatments.

The Five Wishes Document is also similar to a Living Will. It goes beyond traditional living wills by addressing personal, emotional, and spiritual needs alongside medical wishes and care preferences. This comprehensive document combines elements of a Living Will and a Health Care Power of Attorney, offering a holistic approach to end-of-life planning. It allows an individual to specify their personal, emotional, and spiritual preferences in addition to outlining medical treatments they do or do not want, thereby providing guidance that spans both healthcare and personal spheres of caretaking.

A POLST (Physician Orders for Life-Sustaining Treatment) form similarly aims to ensure that a person's wishes regarding medical treatment are followed, especially towards the end of life. Like a Living Will, it details specific preferences about life-sustaining treatments. However, the POLST is more immediate and actionable, being designed for seriously ill or frail individuals in various healthcare settings. It translates personal preferences into medical orders that are meant to be followed by healthcare professionals, ensuring that treatment aligns with the patient’s wishes.

The Advance Directive is a broader term that encompasses several types of healthcare directives, including a Living Will. An Advance Directive can outline both the person’s specific medical treatment preferences, similar to a Living Will, and appoint a healthcare proxy or power of attorney, similar to an HCPOA. It is a versatile document offering both the specific direction on treatments and the appointment of an advocate, offering a comprehensive way to guide healthcare decisions when the individual cannot speak for themselves.

The Medical Orders for Scope of Treatment (MOST) form is another document closely related to the concept of a Living Will. Primarily used in certain jurisdictions, it specifies a patient’s preferences regarding the types of medical intervention and life-sustaining measures they wish to receive. Much like a POLST, it translates these preferences into actionable medical orders, but it is often more detailed and specific in the scope of treatments covered. The MOST form ensures that a patient’s wishes are clearly communicated and adhered to by healthcare providers, bridging personal decisions with professional healthcare practices.

Each of these documents, while distinct in their purpose and application, shares the common goal of enabling individuals to make informed decisions about their healthcare in advance. They offer various means to ensure that one’s preferences for medical treatment, or the refusal thereof, are understood and respected, particularly in situations where direct communication may no longer be possible. By providing clarity and legal weight to these preferences, they play a crucial role in personal and ethical decision-making processes in healthcare.

Dos and Don'ts

When filling out the Wisconsin Living Will form, it's important to carefully follow guidelines to ensure your wishes are clearly stated and legally binding. Below are lists of things you should and shouldn't do during this process.

Things You Should Do

  1. Read all instructions provided with the form thoroughly to understand the requirements and implications of your decisions.
  2. Be clear and specific about your medical treatment preferences, including conditions you want the living will to apply.
  3. Have the document witnessed or notarized as required by Wisconsin law to validate your living will.
  4. Inform your family, healthcare agent, and primary physician about the existence of your living will and provide them with copies.

Things You Shouldn't Do

  1. Don’t fill out the form without fully understanding the medical treatments you are agreeing to or refusing.
  2. Don’t use vague language that could be open to interpretation; clarity is crucial.
  3. Don’t forget to sign and date the form in the presence of the required number of witnesses or a notary public.
  4. Don’t neglect to review and possibly update your living will periodically to ensure it reflects your current wishes.

Misconceptions

When it comes to making important decisions about your health care, understanding what a Living Will means and doesn't mean is crucial. In Wisconsin, like in many other states, a Living Will is an important document where people can express their wishes regarding medical treatment if they ever become unable to make decisions for themselves. However, there are several misconceptions surrounding the Wisconsin Living Will form. Let's clear up some of these misconceptions to help everyone understand its importance and functionality better.

  • A Living Will is the same as a Last Will and Testament: Many people confuse Living Wills with Last Wills and Testaments, but they serve very different purposes. A Last Will and Testament is about your preferences for distributing your property after you die. A Living Will, on the other hand, is about the kinds of medical treatments you would or would not want if you're unable to make decisions due to illness or incapacity. It has nothing to do with your finances or estate.

  • Once you complete a Living Will, it's difficult to change: Some people hesitate to create a Living Will because they worry their choices will be set in stone. However, this is not the case. You can update or revoke your Wisconsin Living Will at any time, as long as you are mentally competent. Changes in your health, personal beliefs, or relationships can all be reasons to review and possibly revise your document.

  • Your family can override your Living Will: A common concern is that family members might not agree with the choices made in a Living Will and could try to override those decisions. In Wisconsin, a properly completed and witnessed Living Will is legally binding. This means that health care providers and your family must respect your wishes as outlined in this document, as long as it complies with state laws.

  • Living Wills are only for the elderly or the terminally ill: Another widespread misconception is that Living Wills are only necessary for older adults or those facing a terminal illness. The truth is that a medical crisis could happen to anyone at any age, making it impossible to communicate one's health care preferences. Having a Living Will in place is a responsible step for any adult, ensuring that your health care wishes are known and considered, no matter what the future holds.

Understanding what a Wisconsin Living Will is—and what it is not—can make a big difference in how you approach planning for your future health care needs. It's about having a say in your health care and ensuring your wishes are respected, no matter what happens. It can also provide peace of mind to you and your loved ones during challenging times.

Key takeaways

Creating a Living Will is an essential step in ensuring your healthcare wishes are honored. The Wisconsin Living Will, specifically designed for residents of Wisconsin, offers a legally binding way to communicate your desires regarding life-sustaining treatment in the event of incapacitation. Here are seven key takeaways to consider when filling out and utilizing the Wisconsin Living Will form:

  • Understand the purpose: A Living Will allows you to express your preferences regarding medical treatment, particularly life-sustaining procedures, in scenarios where you're unable to communicate due to illness or incapacity.
  • Determine eligibility: To execute a Living Will in Wisconsin, you must be 18 years or older and of sound mind at the time of making the document. This ensures that the individual understands the document's significance and implications.
  • Clearly specify wishes: The form enables you to make decisions about the acceptance or refusal of medical treatment, including artificial nutrition and hydration, under certain health conditions. It's crucial to be as clear and detailed as possible.
  • Choose a healthcare agent wisely: While a Living Will does not typically appoint a healthcare agent, considering creating a Durable Power of Attorney for Health Care in conjunction with your Living Will is advisable. This separately designated agent can advocate for your healthcare preferences if you're unable to do so.
  • Follow legal requirements for signing: For your Living Will to be valid in Wisconsin, it must be signed in the presence of two qualified witnesses or a notary public. Witnesses must meet specific criteria, abstaining from being related by blood or marriage or otherwise entitled to any portion of the estate.
  • Communicate your decisions: Once completed, it's crucial to inform your family, healthcare providers, and healthcare agent (if you have one) of your Living Will's existence and its contents. Providing copies to these individuals ensures that your wishes are known and more likely to be followed.
  • Review and update regularly: Life circumstances and health preferences can change. Regularly reviewing and updating your Living Will ensures that it accurately reflects your current wishes. Consider revising it after major life events such as marriage, divorce, the birth of a child, or a significant change in health.

By taking these points into consideration, Wisconsin residents can create a thoughtful and legally sound Living Will that faithfully represents their healthcare preferences. Preparing this document provides peace of mind, knowing that your wishes will be considered during critical healthcare decisions.

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