Homepage Printable Living Will Document Official Living Will Template for Wisconsin
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When individuals consider planning for their future, particularly in terms of healthcare, the Wisconsin Living Will form often becomes an integral part of that conversation. This document, serving as a legal directive, allows people to outline their preferences concerning medical treatment and interventions in scenarios where they are no longer able to communicate their wishes due to severe health conditions. It acts as a guide for family members and healthcare providers, ensuring that the decisions made align with the person's values and desires for end-of-life care. Covering various aspects, from the withholding of life-sustaining measures to the administration of pain relief, the form provides a clear exposition of one's healthcare preferences. Importantly, it offers peace of mind to both the individual and their loved ones, knowing that the care received reflects the person's own choices. The process of completing a living will encourages individuals to think deeply about their health care preferences and to discuss these important decisions with their family and healthcare providers, making it a crucial step in proactive health and legal planning.

Wisconsin Living Will Preview

Wisconsin Living Will Declaration

This Living Will Declaration is made in accordance with the Wisconsin Statutes Chapter 155 - Power of Attorney for Health Care and Living Will. This document allows you to express your wishes concerning life-sustaining procedures if you are diagnosed with a terminal condition or are in a persistent vegetative state. By completing this Living Will, you direct healthcare providers on how to proceed with treatments that may only prolong the dying process.

Please complete the following information to ensure this Living Will accurately reflects your healthcare preferences.

Your Information:

  • Full Name: _____________________________________________________________________
  • Date of Birth: __________________________________________________________________
  • Address: ________________________________________________________________________
  • City, State, Zip Code: ___________________________________________________________
  • Phone Number: __________________________________________________________________

Declaration Statement:

I, ____________________________, being of sound mind, willfully, and voluntarily make known my desire that my dying shall not be artificially prolonged under the circumstances set forth below. I understand the full import of this declaration.

Life-Sustaining Treatment:

If at any time I am unable to communicate my healthcare decisions and I have been diagnosed by two or more physicians to be either in a terminal condition or in a persistent vegetative state with no reasonable expectation of recovery, I direct that:

  1. Life-sustaining procedures be withheld or withdrawn when the burdens of treatment outweigh the benefits I expect to gain, and my condition is deemed irreversible.
  2. Artificially provided nutrition and hydration be withheld or withdrawn, except when needed for comfort care, unless I have indicated otherwise in this document.

Additional Instructions:

________________________________________________________________________________

________________________________________________________________________________

________________________________________________________________________________

Appointment of Health Care Agent: (Optional)

I designate ______________________________________ as my Health Care Agent to make health care decisions for me, consistent with my desires, if I am unable to make such decisions myself.

Agent's Information:

  • Full Name: _____________________________________________________________________
  • Relationship: __________________________________________________________________
  • Phone Number: __________________________________________________________________
  • Alternate Phone Number: _________________________________________________________

This Living Will is executed on the _____ day of ____________, 20____.

Signature: ___________________________________________________

Witness Declaration:

Two witnesses must sign this document. Witnesses must be over the age of 18 and should not be the appointed health care agent or related to you by blood, marriage, or adoption. They cannot be heirs, devisees, or have any claim against your estate.

  • Witness 1 Signature: __________________________________ Date: ____________________
  • Witness 1 Print Name: ___________________________________________________________
  • Witness 2 Signature: __________________________________ Date: ____________________
  • Witness 2 Print Name: ___________________________________________________________

File Attributes

Fact Description
Definition A Wisconsin Living Will is a legal document that outlines a person's wishes regarding medical treatment in the event they become unable to communicate their decisions due to a serious health condition.
Applicable Law The Wisconsin Statutes Chapter 154 governs the creation and use of Living Wills within the state.
Eligibility to Execute Any person who is 18 years of age or older and of sound mind can make a Living Will in Wisconsin.
Requirements for Validity For a Living Will to be valid in Wisconsin, it must be signed by the principal or at the principal's direction in the presence of two qualified witnesses.

Guidelines on Filling in Wisconsin Living Will

A living will is a legal document that lets individuals express their wishes regarding medical treatment if they become unable to communicate or make decisions for themselves due to incapacitation. In Wisconsin, filling out a living will form is a straightforward process designed to ensure that one’s healthcare preferences are known and respected. The following steps guide you through completing the Wisconsin Living Will form to help make this important task as clear and simple as possible.

  1. Begin by obtaining the most current version of the Wisconsin Living Will form. This can often be done by visiting the Wisconsin Department of Health Services website or contacting their office to request a copy.
  2. Read through the entire form before filling in any information, to ensure that you understand the scope and implications of the document.
  3. Enter your full legal name and date of birth in the designated sections at the top of the form to establish your identity as the declarant.
  4. In the section marked for specifying your wishes, clearly indicate which life-sustaining measures you wish to refuse or receive if you are in a state where recovery is not expected. These measures can include artificial nutrition and hydration, ventilator use, and others.
  5. If you have strong preferences about pain relief, specify those in the appropriate section. It's important to note that Wisconsin law allows for individuals to express their wishes regarding the use of medication to alleviate suffering, even if it hastens death.
  6. Appoint a healthcare agent if you wish, by including their name, relationship to you, and contact information. This person will have the authority to make healthcare decisions for you, guided by your living will, if you are unable to do so yourself.
  7. Review the form with your healthcare provider if you have questions or need clarification on medical treatments described in the form. This can help ensure that your decisions are informed and reflect your wishes accurately.
  8. Sign and date the form in the presence of two witnesses or a notary public. Witnesses must be adults who are not your healthcare provider, not related to you by blood or marriage, and do not stand to inherit any of your estate. Their role is to confirm your identity and verify that you are signing the form voluntarily.
  9. After completing the form, make copies and distribute them to key individuals. These should include your healthcare agent (if applicable), family members, and your primary healthcare provider. Keeping a copy in an easily accessible place at home is also a good practice.

Once you have filled out and distributed your Wisconsin Living Will, you have taken a significant step in ensuring that your healthcare preferences are respected. Remember, this document can be updated or revoked by you at any time, should your wishes or situation change. It is also recommended to review the document periodically to ensure it still accurately reflects your desires.

More About Wisconsin Living Will

What is a Wisconsin Living Will?

A Wisconsin Living Will is a legal document that allows an individual to outline their healthcare preferences in the event that they become incapacitated and are unable to communicate their desires. It specifically addresses scenarios where the individual would want or not want life-sustaining measures.

Who should have a Wisconsin Living Will?

Any adult resident of Wisconsin who wishes to have control over their medical treatment and ensure their healthcare preferences are respected should consider creating a Living Will. It's especially important for those with strong feelings about certain medical treatments or those with serious medical conditions.

What decisions can be made with a Wisconsin Living Will?

  • Use or non-use of life-sustaining measures if you are in a vegetative state or permanently unconscious
  • Decisions regarding the initiation or continuation of artificial nutrition and hydration
  • Preferences for certain types of pain management, including palliative care
  • Any specific medical treatments you do or do not want in end-of-life situations

How can someone create a Living Will in Wisconsin?

To create a Living Will in Wisconsin, one must complete the Living Will form, also known as a Declaration to Physicians (Wisconsin Statutes § 154.03). This form must be signed in the presence of two witnesses, who also need to sign the document. Witnesses must meet certain criteria, such as not being healthcare providers directly serving the declarant at the time of the declaration or not being related by blood, marriage, or adoption.

When does a Wisconsin Living Will take effect?

A Wisconsin Living Will becomes effective when it is delivered to your attending physician and you are determined to be incapacitated and in a condition specified in the Living Will, such as a persistent vegetative state or terminal illness. Until such conditions are met and the document is presented to your physician, the Living Will does not come into effect.

Can a Wisconsin Living Will be revoked?

Yes, at any time and without regard to the declarant's mental or physical condition, a Wisconsin Living Will can be revoked. This can be done in several ways: by destroying the document; by a written revocation signed and dated by the declarant or someone acting at the direction of the declarant; or by orally expressing the intent to revoke in the presence of a witness who is 18 years of age or older, who then signs and dates a written confirmation of the revocation.

Does a Living Will replace a Power of Attorney for Health Care?

No, a Living Will does not replace a Power of Attorney for Health Care in Wisconsin. While a Living Will provides specific instructions about life-sustaining treatment, a Power of Attorney for Health Care appoints someone to make a range of health care decisions on your behalf, not only those related to life-sustaining treatment. Many people have both documents to cover a broader spectrum of healthcare decisions.

How is a Living Will different from a Do Not Resuscitate (DNR) order?

A Living Will is primarily a declaration of one's preferences for treatment in the event of a terminal illness or permanent unconsciousness, including whether to administer life-sustaining measures. A Do Not Resuscitate (DNR) order is a doctor's order that prevents medical staff from performing CPR in case your heart stops or you stop breathing. A DNR focuses solely on the event of cardiac or respiratory arrest, while a Living Will addresses a broader range of end-of-life treatments.

Is a lawyer required to complete a Wisconsin Living Will?

While a lawyer is not required to complete a Wisconsin Living Will, consulting with one can be helpful to ensure the document accurately reflects your wishes and is completed correctly. A lawyer can also advise on how a Living Will works in conjunction with other estate planning documents you may have.

Common mistakes

When individuals embark on the task of filling out a Wisconsin Living Will form, it is crucial for them to approach the document with thoroughness and caution. A Living Will is an essential legal document that specifies a person's wishes regarding medical treatment in the event that they are unable to communicate their decisions due to illness or incapacity. Despite its importance, certain mistakes are commonly made during its completion.

  1. Not fully understanding what the form entails: People often fill out the Wisconsin Living Will without a full grasp of its scope. This legal document addresses very specific medical decisions, such as the use of life-sustaining measures and end-of-life care. Not comprehending the implications of these decisions can lead to choices that might not truly reflect the person’s wishes.

  2. Inconsistent information: There may be inconsistencies between what is stated in the Living Will and other legal documents such as a Durable Power of Attorney for Health Care. These inconsistencies can lead to confusion and possibly legal challenges, complicating the implementation of the person's wishes at a critical time.

  3. Not updating the form: People's preferences regarding medical treatment and end-of-life care can change over time due to various factors, such as aging, personal experiences, or shifts in viewpoint. Failing to update the Living Will to reflect these changes can result in a document that no longer aligns with their current wishes.

  4. Forgetting to discuss the Living Will with family and healthcare providers: A critical oversight is not communicating the existence and content of the Living Will to family members and healthcare providers. This lack of communication can lead to uncertainty and disputes about the person’s healthcare wishes if they become incapacitated.

In addition, it's helpful to be mindful of the details that should be included in a Wisconsin Living Will form:

  • Fully identifying personal information to avoid any identification errors.

  • Clearly specifying which life-sustaining treatments should be used or withheld under specific conditions.

  • Including any additional wishes or directions that may not be covered by standard living will clauses, ensuring these wishes are in line with Wisconsin law.

  • Ensuring the form is properly signed, dated, and witnessed according to the state requirements to ensure its legal validity.

By avoiding these mistakes and giving careful attention to the completion of the Wisconsin Living Will form, individuals can make sure it accurately reflects their healthcare preferences and legal requirements, offering peace of mind to themselves and their loved ones.

Documents used along the form

When preparing a Living Will in Wisconsin, it's crucial to consider other documents that enhance and support your healthcare and end-of-life wishes. These documents can provide a comprehensive approach to your healthcare planning, ensuring your preferences are known and respected even when you can't communicate them yourself. Let's take a look at some of these important documents that are often used alongside the Wisconsin Living Will form.

  • Health Care Power of Attorney: This document allows you to appoint someone you trust to make healthcare decisions on your behalf if you become unable to do so. It complements your Living Will by covering health care decisions that may not be specifically addressed in the latter.
  • Do Not Resuscitate (DNR) Order: A DNR order tells medical personnel not to perform CPR if your breathing stops or if your heart stops beating. It's particularly important for individuals with serious illness or at the end of life who wish to avoid aggressive life-saving interventions.
  • Declaration to Physicians (Wisconsin’s version of a POLST): This document goes a step further than a DNR by providing specific instructions about other life-sustaining treatments, like ventilation or feeding tubes, in addition to CPR. It is usually for people with a serious illness or frailty near the end-of-life.
  • Organ and Tissue Donation Registration: By registering to be an organ and tissue donor, you can express your wish to donate your organs and tissues after death. This decision can be documented separately or sometimes included within the Health Care Power of Attorney form.
  • Funeral Planning Declaration: This document allows you to outline your preferences for your funeral arrangements, including the type of ceremony, burial or cremation, and even specifics like music or readings. It helps ensure your wishes are respected and relieves your loved ones of the burden of making these decisions during a difficult time.

Together, these documents form a comprehensive plan that addresses various aspects of your healthcare and end-of-life preferences. While a Living Will specifies your wishes regarding life-sustaining treatments, the additional documents ensure someone can make decisions on your behalf, your intentions regarding resuscitation and other treatments are clear, your desire to donate organs and tissues is known, and your funeral plans are set. It's essential to consider each of these documents when planning for the future, as they can provide peace of mind for you and your loved ones.

Similar forms

The Wisconsin Living Will form is similar to the Health Care Power of Attorney form in several ways. Both documents allow individuals to outline their healthcare preferences in advance, but they do so in slightly different contexts. The Living Will specifically addresses end-of-life decisions, including the refusal of or request for life-sustaining treatments when an individual is no longer able to communicate their wishes due to a terminal condition or persistent vegetative state. On the other hand, a Health Care Power of Attorney gives a designated agent the authority to make a broader range of healthcare decisions on behalf of the individual, should they become incapacitated, not limited to end-of-life situations.

Additionally, the Wisconsin Living Will form shares similarities with the Do Not Resuscitate (DNR) Order. Both documents guide healthcare professionals on how to proceed with treatment in critical situations. However, their scopes are quite different. A Living Will expresses wishes regarding the use of life-sustaining measures in a broader sense, taking effect when an individual is terminally ill or in a persistent vegetative state. Conversely, a DNR Order specifically instructs healthcare providers not to perform CPR if an individual's heart stops or if they stop breathing. This document is often used by individuals with a serious illness or condition where CPR would not be beneficial or desired.

Dos and Don'ts

Completing a Wisconsin Living Will is a responsible step in planning for future healthcare decisions. It ensures your wishes are known should you be unable to communicate them yourself. When filling out this form, certain practices should be followed to ensure it accurately reflects your wishes and complies with Wisconsin law. Here are five essential do's and don'ts to consider:

Do:

  1. Read the form thoroughly before beginning to ensure you understand each section and its purpose.
  2. Use clear and concise language to describe your healthcare choices, avoiding any ambiguity.
  3. Discuss your decisions with healthcare professionals and loved ones to ensure they understand your wishes.
  4. Sign and date the form in the presence of two qualified witnesses or a notary public, as required by Wisconsin law.
  5. Keep the original document in a safe but accessible place, and provide copies to your healthcare agent, close family members, and your primary physician.

Don't:

  • Fill out the form when you're feeling rushed or under pressure. Take your time to carefully consider each decision.
  • Use terms or phrases that might be open to interpretation. Be as specific as possible with your instructions.
  • Forget to update your Living Will if your wishes change. Review it regularly and make necessary adjustments.
  • Assume your family knows what you want. Explicitly discuss your wishes with them to minimize any confusion or disputes later on.
  • Rely on this document alone for all end-of-life decisions. Consider complementing it with a Power of Attorney for Health Care to cover decisions not specified in your Living Will.

Misconceptions

When it comes to planning for future healthcare decisions, understanding the Wisconsin Living Will is crucial. However, there are several misconceptions about this document that can lead to confusion. Let’s clear up some of these misunderstandings:

  • It’s only for the elderly: A common misconception is that a Living Will is only necessary for older adults. In reality, any adult can face sudden illness or injury, making it important for all adults to express their healthcare wishes in advance.

  • It covers all medical decisions: Some may think a Living Will covers all types of medical decisions. However, it's specifically designed to express wishes regarding life-sustaining treatment when one is incapacitated and unable to communicate. Other healthcare decisions require a different document, such as a Power of Attorney for Healthcare.

  • Your family can override it: There’s a belief that family members can override the wishes outlined in a Living Will. In Wisconsin, a Living Will is legally binding, meaning healthcare providers are required to follow it, even if family members disagree with its directives.

  • It takes effect as soon as it’s signed: Some people think that a Living Will takes effect immediately after it's signed. The truth is, it only becomes effective when the individual cannot make their own healthcare decisions, as certified by one or more physicians.

  • You need a lawyer to create one: It’s often assumed that drafting a Living Will requires legal assistance. While consulting a lawyer can be helpful, especially in complex situations, anyone can create a Living Will by filling out the appropriate Wisconsin form and following the state's signing and witnessing requirements.

  • It’s difficult to change or cancel: People might hesitate to complete a Living Will, thinking it’s hard to change or cancel. In fact, amending or revoking a Wisconsin Living Will can be done at any time by the person who created it, provided they are competent to do so. This ensures that individuals can adjust their directive as their wishes or circumstances change.

Addressing these misconceptions is essential for empowering individuals to make informed decisions about their future healthcare, ensuring their wishes are respected. Preparing a Living Will is a proactive step toward this goal.

Key takeaways

Preparing a Living Will in Wisconsin is a significant step in managing your future health care decisions. Here are several important aspects to consider:

  1. Completeness is crucial. When you're filling out your Wisconsin Living Will form, make sure to provide clear and comprehensive details about your health care preferences. This document speaks for you when you can't, so clarity is key.

  2. Sign in the presence of witnesses. Wisconsin law requires that your Living Will (also known as a Declaration to Physicians) be signed in the presence of two qualified witnesses. These witnesses must meet certain criteria, so choose them carefully.

  3. Update as necessary. Life changes, and so might your health care wishes. Regularly review your Living Will and update it to reflect your current preferences and life circumstances.

  4. Communicate with loved ones. Sharing the contents of your Living Will with family members and close friends can ease potential tension or confusion in difficult times. It ensures that your wishes are known and can be advocated for.

  5. Keep it accessible. A Living Will is only useful if it can be found and used when needed. Make sure your health care provider, your health care agent (if you have designated one), and any other relevant parties have copies.

  6. Know its limitations. While a Living Will is powerful, it has its boundaries. Understand what it can and cannot do under Wisconsin law, and consider complementary documents like a Power of Attorney for Health Care to fill any gaps in your health care directives.

Filling out a Wisconsin Living Will is both a responsible and proactive step to take. It not only helps to ensure that your health care wishes are known and respected but also provides peace of mind to you and your loved ones.

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