A Living Will allows you to record your wishes regarding medical care in the event that you become unable to communicate them yourself. While many people have heard of the term, they may not be sure how to make effective use of it.

In Western countries, expressions of personal wishes are often categorized according to when they take effect. Instructions concerning decisions during one’s lifetime are referred to as a Living Will, while instructions concerning matters after death are generally referred to as a Will.

From this perspective, decisions regarding end-of-life medical care fall under a Living Will because they concern care provided while a person is still alive. By contrast, a Last Will and Testament deals with matters that take effect after death and is therefore classified as a Will.

Thinking about the distinction in this way may help clarify what should be included in a Living Will.

One important point to understand is that a Living Will does not have clear legally binding force in Japan.

Therefore, there is no legal guarantee that the wishes expressed in a Living Will will always be carried out exactly as written.

For example, if a person is transported to a hospital after losing consciousness and the medical team is unaware that a Living Will exists, treatment will likely be provided based on what is considered medically appropriate at that time, regardless of the person’s previously stated wishes.

Even when a Living Will is available, there may be situations in which family members strongly disagree with its contents. In such cases, healthcare professionals may face difficult decisions, and the patient’s wishes may not be fully respected.

To reduce the likelihood of such situations, it is advisable to discuss your wishes thoroughly with your family when preparing a Living Will.

It is also important to clearly communicate your wishes to your family after the document has been completed.

If you have a regular healthcare provider or receive long-term care services, discussing your wishes with the professionals involved may also increase the likelihood that your preferences will be honored when the time comes.

Discussing end-of-life care with the people around you and sharing your wishes in advance is, in essence, what Advance Care Planning (ACP) is all about.

Creating a Living Will is not the final goal.

What matters is sharing its contents with your family (or trusted friends, healthcare proxies, or other representatives) as well as with healthcare and caregiving professionals, so that an environment is in place where your wishes can be respected when they matter most.

In the next article, we will look at the specific types of information that should be included in a Living Will.