These critical documents about your preferences for end-of-life care don't always work as planned. More flexibility might be the answer.

Making end of life decisions means generating and updating your living will (or advance health care directive). These documents often appear simple, but that doesn’t mean the underlying issues themselves aren’t complex.

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According to a recent article in The Wall Street Journal titled “A New Look at Living Wills,” unfortunately these issues are only growing increasingly complex.

In its essence, the living will is a document in which you clarify your medical wishes. This allows your loved ones to implement them if you are incapacitated and unable to reflect upon them yourself in the future. Given modern medical science, doctors can keep a human body “alive” long after the “person” inside has lost what he or she would have regarded as a minimally acceptable quality of life.

With each new advance in medical science, there seem to be more and more ethical and legal dilemmas. For example, the typical living will contemplates feeding tubes and respirators, but these can maintain a “persistent vegetative state” leading to shades of gray for the appointed health care agent and physician as they interpret your wishes. Moreover, the boundary between the patient being “there” or “not there” is only getting hazier as science progresses. In the end, even physicians don’t always seem to understand the power they may be wielding over life and death.

Planning for your end-of-life scenarios is never easy, nor is it easy to faithfully interpret the wishes of a loved one. Nevertheless, as with all aspects of estate planning, communication with your agents, loved ones, physician and spiritual advisor holds the key to success as you define it.

Reference: The Wall Street Journal (June 8, 2012) “A New Look at Living Wills