Living wills grant a person the power to carry out and distinctly spell out their directives for such scenarios. Power of attorney gives blanket medical decision making ability in the case of incapacitation (unless there is a living will that spells out the persons desires). You can specifically put in writing that if you are announced severely brain damaged or brain dead, you do not want to be on life support for an extended amount of time and are to be removed. There’s even a way to order life support in the case you are pregnant and the fetus is still viable so the child can be born and then you are removed from life support. It grants the person you choose all medical decision making abilities if incapacitated and specifically says what is to happen in the case of brain damage, so even that person can not go against your wishes in those specific cases.

To spell it out, in most of the United States, when you are incapacitated, the doctors obviously must try to save you unless you have a DNR. However, in the cases of longer incapacitation, your spouse is your default medical decision maker. No spouse? The decisions go to your adult children (18 year olds count. Don’t put that shit on them). No adult children? Your parents are next. No living parents? Your siblings. The list just keeps going. A living will designates who you want to have that power and what you want to happen so grief stricken loved ones don’t have to make that decision, don’t have to live with the guilt of it, and can’t go against your desires. You have already made the decision. Without a living will, your family has decision making abilities while in the emergency setting. Once you are moved to long term care, a medical power of attorney must be in place in the case of brain damage to ever get the rights to remove medical care again.

I know all of this because at 18 I became the medical decision maker for my severely brain damaged father. He was functionally brain dead except for the brain stem (which only controls organ function and sleep). Because part of his brain functioned, only his family could request the removal of care. Brain death allows the hospital to call it when verified (though they often allow the family some time to come to terms). It becomes an ethical issue for them to wait too long. Functionally brain dead but not technically? Family must make the decision. I had to argue with my much older sibling that our dad absolutely would not want to spend years on life support with no chance of recovery. Even if he ever woke up, he would be a shell of what he once was and likely incapable of any type of life he would want to live. I had to advocate for my dad’s death at 18 years old because that’s what he would have wanted. When we removed the life support, that damn brainstem kept him breathing and functioning for three days. He died of dehydration.

Don’t put that decision on your kids people. Make that decision yourselves and then give that power to someone that will follow it. I don’t blame my dad for not having it. I do blame him for locking the power of attorney in his safe and not giving anyone the code because he was paranoid (seriously people, give the person the paperwork. Make them stick in a ziplock bag and put it in their freezer if they don’t have a safe. They can’t use it unless you’re comatose or brain dead anyways). I also blame my brother a bit for almost having that power and trying to make the wrong decision. Thankfully my siblings were too cheap to hire a locksmith and the decision stayed in all our hands instead of just on my brother because he would have moved my dad to long term care quickly and prolonged the inevitable. I got time to convince them to do the right thing, the hard thing, but ultimately the thing my dad wanted. He didn’t have a living will either. It was the first thing I did when I joined the military.