Homepage Printable Living Will Document Official Living Will Template for Iowa
Article Structure

At the heart of preparing for the future, especially in terms of health care, lies the critical yet often overlooked document known as the Iowa Living Will. This legal instrument allows individuals to outline their preferences for medical treatment and life-sustaining measures in the event that they are no longer able to communicate their decisions due to a serious health condition. It stands as a testament to one's autonomy, giving them the power to dictate the course of their medical care based on their personal values, beliefs, and wishes. The Iowa Living Will form encompasses a variety of important aspects, including the designation of a health care proxy or durable power of attorney for health care, specific treatments one wishes to avoid, such as mechanical ventilation or artificial nutrition and hydration, and instructions for end-of-life care. Through this document, individuals can ensure that their health care providers and loved ones are aware of their preferences, thereby reducing the burden of making difficult decisions during emotionally challenging times. Moreover, this form serves a dual purpose by not only guiding medical professionals in respect to patient care but also in aligning treatment plans with the patient's wishes, thus ensuring that the person's autonomy is respected even when they cannot speak for themselves.

Iowa Living Will Preview

Iowa Living Will Template

This document, an Iowa Living Will, is designed to meet the requirements set forth in the Iowa Living Will Act (Iowa Code Chapter 144A). It is a legally binding document that records the wishes of an individual (hereafter known as the "Principal") regarding their medical treatment in situations where they are unable to communicate or make decisions due to a terminal condition or permanent unconsciousness.

Principal Information

  • Full Name: ___________________________
  • Date of Birth: ________________________
  • Address: ______________________________
  • City: ___________ State: Iowa Zip: _________

Living Will Declaration

I, _________________ (Principal's full name), being of sound mind and legal age, do hereby declare:

In the event that I suffer from a terminal condition or permanent unconsciousness, where my attending physician and another medical professional both conclude that there is no reasonable expectation of my recovery to a meaningful quality of life, I direct that the following treatments be withheld or withdrawn:

  1. Life-sustaining procedures that serve only to prolong the dying process
  2. Artificial nutrition and hydration
  3. Artificially administered respiration
  4. Any other medical or surgical procedures that provide no medical benefit to me and serve only to delay inevitable death

It is my intention that this living will be honored by my family, physicians, and other healthcare providers as the final expression of my legal right to refuse medical treatment, even if the cost of refusing treatment might hasten my death.

Designation of Health Care Advocate (Optional)

If I am unable to make my own health care decisions, I designate the following individual as my Health Care Advocate:

  • Name: ___________________________
  • Relationship: ____________________
  • Phone: ___________________________
  • Address: __________________________

My Health Care Advocate shall have the authority to make any health care decisions on my behalf, according to the wishes I have expressed in this document, to the extent permitted by law.

Signature

This document is signed voluntarily by me, the Principal, as my Living Will, on this___ day of _____________, 20____.

  • Principal's Signature: ___________________________
  • Printed Name: _________________________________

Witness Statement

We, the undersigned witnesses, declare that the Principal appears to be of sound mind and under no duress, fraud, or undue influence. We are not the designated Health Care Advocate, nor are we healthcare providers or employees of a healthcare facility where the Principal is receiving care. Additionally, we are not related to the Principal by blood, marriage, or adoption, and we do not stand to inherit any part of the Principal’s estate upon their death.

  • Witness 1 Signature: ___________________________
  • Printed Name: ________________________________
  • Date: ________________________________________
  • Witness 2 Signature: ___________________________
  • Printed Name: ________________________________
  • Date: ________________________________________

File Attributes

Fact Number Fact Detail
1 The Iowa Living Will is officially known as the "Declaration Relating to Use of Life-Sustaining Procedures."
2 It is governed by the Iowa Code Chapter 144A, covering "Durable Power of Attorney for Health Care and Declaration Relating to Use of Life-Sustaining Procedures."
3 This legal document allows individuals in Iowa to state their preferences regarding the acceptance or refusal of life-sustaining treatment if they are incapacitated and unable to make medical decisions themselves.
4 To be legally valid, the form must be signed by the declarant in the presence of two adult witnesses who are not related by blood, marriage, or adoption and do not stand to inherit from the declarant.
5 Witnesses cannot be the declarant's health care provider, an employee of the health care provider, nor the operator or an employee of a health care facility where the declarant is a patient.
6 If a patient is pregnant, the Iowa Living Will is not effective to refuse life-sustaining procedures that could maintain the patient until the birth of the child.
7 Individuals can modify or revoke their Iowa Living Will at any time through a signed and dated written statement, by a verbal indication to a health care provider, or by destroying the document.
8 The form does not require notarization in Iowa to be considered valid.

Guidelines on Filling in Iowa Living Will

When it comes time to plan for future healthcare decisions, an Iowa Living Will is a vital document that allows you to express your wishes regarding the types of medical treatment you want to receive, or refuse, in the event you are unable to communicate those wishes yourself. This legal document is straightforward to fill out but requires careful consideration to ensure your healthcare preferences are clearly laid out. Below are the steps needed to complete an Iowa Living Will, crafted to make this process as easy as possible for you.

  1. Start by gathering your personal information. This includes your full legal name, address, and date of birth. Having this information at hand will streamline the process.
  2. Enter your personal information at the top of the form where indicated. Make sure all details are accurate to avoid any confusion.
  3. Review the healthcare options presented in the form. These include decisions on life-sustaining treatments, artificial nutrition, and hydration. Reflect on your values and how they align with your healthcare wishes.
  4. Specify your choices regarding the acceptance or refusal of life-sustaining treatment and artificial nutrition and hydration. It's crucial to be clear and decisive in your selections to ensure your wishes are understood.
  5. Consider appointing a healthcare power of attorney if you haven't already. This person will make healthcare decisions on your behalf based on your living will's guidelines. If you decide to appoint someone, their name and contact information must be included in the specified section of your living will.
  6. Review your completed document to ensure all information is correct and reflects your healthcare wishes accurately. Look for any sections you might have missed or any choices that don't quite capture your intentions.
  7. Sign and date the form in the presence of a notary public or two witnesses who are not related to you and do not stand to inherit anything from your estate. Their signatures will validate your living will.
  8. Finally, distribute copies of the signed document to your healthcare providers, healthcare power of attorney (if applicable), and a trusted family member or friend. It's important to keep the original document in a safe but accessible place.

Completing an Iowa Living Will is a proactive step towards ensuring your healthcare wishes are respected, even when you're unable to communicate them. This process not only gives you peace of mind but also aids your loved ones and healthcare providers in making decisions that align with your values and desires. Taking the time now to articulate your healthcare preferences can make a significant difference in the future.

More About Iowa Living Will

What is a Living Will form in Iowa?

A Living Will form in Iowa is a legal document that lets individuals outline their preferences regarding medical treatment in circumstances where they are not able to communicate their wishes. This may happen if they are terminally ill or in a permanent unconscious state. The form allows people to make decisions about life-sustaining treatments, including whether or not they want such treatments to be started, continued, or stopped.

Who should have a Living Will?

Every adult who wishes to have control over their medical treatment should consider creating a Living Will. It's especially important for those with strong feelings about what types of life-sustaining treatments they would or wouldn't want if they're unable to make decisions for themselves. Having a Living Will can also relieve family members from the burden of making tough decisions during stressful times.

How can someone create a Living Will in Iowa?

Creating a Living Will in Iowa involves several steps:

  1. Finding the Iowa Living Will form. This can typically be obtained online from legal websites, healthcare organizations, or from an attorney.
  2. Completing the form according to personal healthcare preferences. It's crucial to be clear and specific about what treatments one would or would not want.
  3. Getting the form notarized or witnessed, as required by Iowa law. This usually requires signing the form in front of notary public or certain types of witnesses.
  4. Informing family members and healthcare providers about the Living Will and giving them copies. This ensures that the instructions are followed.

Can a Living Will be changed or canceled?

Yes, a Living Will in Iowa can be changed or canceled at any time by the person who created it. Changes or cancellation can be made by:

  • Creating a new Living Will that states new preferences and/or revokes the old one.
  • Physically destroying the original document with the intent to cancel it.
  • Expressing the intent to cancel the Living Will through a written, signed, and dated statement.
  • Verbally expressing the wish to cancel the Living Will in front of a witness, who must then sign and date a written statement confirming the cancellation.
It's important to notify healthcare providers and anyone else who was given a copy of the original Living Will after making changes or canceling it.

Common mistakes

  1. Not specifying personal wishes clearly. It's crucial to articulate your desires regarding life-sustaining treatment and end-of-life care in explicit terms. Vagueness can lead to interpretations that might not align with your true intentions.

  2. Failure to update the document. Life changes such as new diagnoses, treatments, or personal circumstances necessitate updates to ensure the living will reflects your current wishes and health status.

  3. Omitting a durable power of attorney for health care. While filling out the living will, it's advisable to also appoint a trusted person as your health care agent. This person will make decisions on your behalf if you're unable to do so.

  4. Not discussing wishes with the appointed health care agent. It's not enough to select someone; you must also discuss your wishes with them thoroughly. Failure to communicate clearly can result in decisions that don't reflect what you would have wanted.

  5. Overlooking the need for witness signatures or notarization. Depending on state requirements, a living will may need to be either witnessed or notarized, or both, to be legally binding.

  6. Ignoring state-specific requirements. Laws regarding living wills vary by state. It's essential to ensure your living will complies with Iowa's specific laws to avoid any legal issues.

  7. Incorrectly filing the document. Simply completing the form isn't enough. You must file it correctly, often with your primary care physician and by making loved ones aware of its existence, to ensure it is honored.

Documents used along the form

When preparing for one’s future health care decisions, many individuals in Iowa choose to complete a Living Will as part of their planning process. A Living Will is crucial for outlining one's preferences concerning medical treatments and life-sustaining measures in situations where they cannot communicate their wishes themselves. Alongside a Living Will, several other important forms and documents often support and supplement the individual's decisions, ensuring a comprehensive approach to end-of-life planning and health care directives.

  • Durable Power of Attorney for Health Care: This document allows an individual to appoint another person, known as an agent, to make health care decisions on their behalf if they are unable to communicate their wishes. Unlike a Living Will, this power of attorney is broader because it covers any decision the individual could make about health care, not just those involving life-sustaining treatment.
  • Do Not Resuscitate (DNR) Order: A DNR Order is a medical order written by a doctor instructing health care providers not to perform CPR if the patient's breathing stops or if the patient's heart stops beating. It is used if someone wishes to avoid certain life-sustaining measures.
  • Physician Orders for Scope of Treatment (POST): Similar to a DNR, a POST form provides medical orders concerning the extent of treatment an individual wants during a medical emergency. This can include preferences about CPR, intubation, and other life-sustaining treatments.
  • Declaration for Mental Health Treatment: This form lets an individual make decisions in advance about mental health treatment, in case they become unable to make those decisions themselves. It can specify which treatments they would accept or refuse and can even appoint an agent to make decisions about mental health treatment.
  • HIPAA Release Form: The Health Insurance Portability and Accountability Act (HIPAA) keeps health information private. A HIPAA release form is necessary when individuals want to allow their health care providers to disclose their health information to designated persons or entities.
  • Organ and Tissue Donation Registration: This document allows individuals to register their consent to donate their organs and tissues upon death. It is an important addition for those who want to make this generous decision part of their end-of-life planning.

Together with a Living Will, these documents form a comprehensive network of plans that express one’s healthcare and end-of-life preferences clearly. Each plays a unique role in ensuring that an individual's health care choices are respected and followed, emphasizing the importance of personal autonomy in medical decision-making. Proper preparation and understanding of each document can provide peace of mind to individuals and their families during difficult times.

Similar forms

The Iowa Living Will form is similar to several other documents used in estate planning and health care decision-making. These documents include the Health Care Power of Attorney, the Do Not Resuscitate (DNR) Order, and the Advance Directive. Each serves a unique role, but they all aim to ensure a person's health care preferences are known and respected, especially when the person can no longer communicate those wishes.

Health Care Power of Attorney (HCPOA): This document is akin to a Living Will in that it deals with medical decision-making. However, while a Living Will specifies your wishes regarding life-sustaining treatments, a Health Care Power of Attorney allows you to appoint someone else (a "health care agent") to make medical decisions on your behalf if you're unable to do so yourself. This can include decisions beyond those pertaining to life-sustaining treatments, offering a broader scope of control over one's medical care.

Do Not Resuscitate (DNR) Order: A DNR is a written order from a doctor that prevents medical personnel from performing cardiopulmonary resuscitation (CPR) if a patient's breathing stops or if the patient's heart stops beating. It is similar to a Living Will in its focus on a specific medical situation where life-sustaining treatment is declined. Like a Living Will, it is designed to respect the patient's wishes at a critical time; however, it is much more narrowly focused and medically specific.

Advance Directive: Often, an Advance Directive is considered a broader term that can include aspects of a Living Will and a Health Care Power of Attorney. It is a document, or a set of documents, that guide choices for doctors and caregivers if you're terminally ill, seriously injured, in a coma, in the late stages of dementia, or near the end of life. While similar to a Living Will in its purpose to outline medical preferences, an Advance Directive typically encompasses both the appointment of a health care agent (as in a HCPOA) and specifics about treatment preferences (as in a Living Will).

Dos and Don'ts

Completing the Iowa Living Will form is a significant step in planning for future healthcare decisions. It's a legal document that outlines your wishes regarding medical treatments or interventions you would prefer or refuse if you are ever unable to communicate those decisions yourself. When filling out this crucial document, here are some dos and don'ts to keep in mind:

  • Do read the entire form carefully before filling it out. Understanding every section will help ensure that your intentions are clearly communicated.
  • Do consult with a healthcare professional if you have questions about medical terms or treatments mentioned in the form. Their expertise can help you make informed decisions.
  • Do discuss your wishes with your family and loved ones. Sharing your decisions can help prevent conflicts or confusion during difficult times.
  • Do consider the appointment of a healthcare power of attorney. This is a person who can make healthcare decisions on your behalf if you're unable to do so.
  • Do sign and date the form in the presence of a notary public or the designated witnesses as required by Iowa law. This step validates the document.
  • Don't leave any sections blank if they are applicable to your wishes. An incomplete form might lead to unwanted interpretations or actions.
  • Don't assume that your healthcare providers are automatically aware of your living will. Take the responsibility to inform them and provide a copy for your medical records.
  • Don't forget to review and update your living will periodically. Your preferences might change over time, and it’s essential to ensure the document reflects your current wishes.
  • Don't hesitate to seek legal advice if there are any aspects of the living will that are unclear to you. A legal professional can offer clarity and guidance to make sure your rights are protected.

Adhering to these guidelines can help ensure your Iowa Living Will form accurately represents your health care preferences and is considered valid and effective when it matters most. Remember, planning ahead with a living will is a thoughtful way to communicate your wishes and relieve your loved ones from the burden of making those difficult decisions on your behalf.

Misconceptions

When it comes to the Iowa Living Will, there are several misconceptions that may influence how individuals approach this important document. Understanding these common misunderstandings can help ensure your healthcare wishes are clearly expressed and followed.

  • Only the elderly need a Living Will. People of all ages can face medical emergencies or unexpected health care decisions. A Living Will allows anyone over the age of 18 to outline their healthcare preferences in advance.

  • A Living Will is the same as a Last Will and Testament. A Living Will specifically addresses health care decisions, such as life support, during your lifetime. In contrast, a Last Will and Testament deals with the distribution of your estate after your death.

  • Once signed, a Living Will cannot be changed. You have the right to revise or revoke your Iowa Living Will at any time, as long as you are mentally competent to do so.

  • Creating a Living Will is a complicated process. While it's important to carefully consider your decisions, the process of creating a Living Will in Iowa is straightforward. It must be signed, dated, and either witnessed by two individuals or notarized.

  • A lawyer is necessary to create a Living Will. While legal advice can be beneficial, especially in complex situations, you do not need a lawyer to create a viable Living Will in Iowa.

  • A Living Will means "do not treat." A common misconception is that having a Living Will equates to refusing all treatments. In reality, it allows you to specify which treatments you do or do not want in particular situations.

  • My family can override my Living Will. In Iowa, a Living Will is legally binding. This means healthcare providers are required to follow your wishes as outlined, and family members cannot override these directives.

  • Living Wills only apply if you have a terminal illness. While a Living Will is often associated with terminal illnesses, it can also specify wishes regarding temporary unconsciousness, irreversible coma, or other serious conditions.

Key takeaways

Filling out and using the Iowa Living Will form is an important step for any adult considering their healthcare and end-of-life decisions. Here are key takeaways to remember during this important process:

  1. Understand what a Living Will means in Iowa. It's a legal document that outlines what medical treatments you would or would not want to prolong your life if you're unable to make decisions yourself.
  2. Know that the Iowa Living Will becomes effective only under specific circumstances, primarily when you are incapacitated and have a terminal condition, or are in a persistent vegetative state, as determined by a physician.
  3. Ensure you meet the requirements for executing a Living Will in Iowa, which includes being of sound mind and at least 18 years old.
  4. Discuss your healthcare desires with healthcare providers, family members, or a trusted advisor before completing the form. Their understanding of your wishes is crucial in enforcing your Living Will.
  5. Complete the Iowa Living Will form carefully. You must clearly specify your healthcare choices, particularly about life-sustaining treatments and artificially provided nutrition and hydration.
  6. Seek the required witnesses or notarization for your Living Will to be legally binding in Iowa. This typically means having two witnesses, not related to you, who will not inherit from your estate and are not your healthcare providers.
  7. Keep your completed Living Will accessible. Inform your family, healthcare agent, and doctors of its existence and where the original document is stored.
  8. Understand you can revoke or change your Living Will at any time, provided you are of sound mind. This can be done by creating a new Living Will, by physically destroying the original document, or by making a clear statement of intent to revoke.
  9. Review and possibly update your Living Will periodically or with changes in your health status or personal wishes. Life events such as marriage, divorce, the birth of a child, or a significant change in health can all warrant a review of your Living Will.
  10. Consider pairing your Living Will with a durable power of attorney for healthcare. This allows someone you trust to make healthcare decisions on your behalf, according to your wishes outlined in your Living Will, if you're incapacitated.

By following these key points, you can take a significant step toward ensuring your healthcare wishes are respected, even when you can't speak for yourself. A well-prepared Living Will provides peace of mind to you and your loved ones.

Please rate Official Living Will Template for Iowa Form
4.7
Exceptional
203 Votes