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When contemplating the management of health care wishes, especially in situations where one may not be able to express their desires personally, the Iowa Living Will form presents a crucial document to consider. This form allows individuals to outline their preferences for medical treatment and end-of-life care in advance, ensuring that their wishes are known and can be followed by family members and healthcare providers. By completing this form, residents of Iowa take a significant step towards maintaining control over their medical care, even in circumstances when they might not be able to communicate their wishes directly. The Iowa Living Will is not just about making tough decisions in advance; it's about peace of mind. It signifies a person's autonomy over their body and future, providing a clear directive to healthcare professionals and relieving loved ones of the heavy burden of making such critical decisions during stressful times. Understanding the major aspects of this form is essential for anyone looking to safeguard their health care preferences and alleviate potential emotional turmoil for family members.

Sample - Iowa Living Will Form

Iowa Living Will Template

This Living Will is established in accordance with the Iowa Uniform Power of Attorney Act specific to the State of Iowa, recognizing the right of individuals to control decisions relating to their own medical care, including the decision to have life-sustaining procedures withheld or withdrawn in instances where recovery is not expected.

Personal Information

  • Full Name: ___________________________________________________
  • Date of Birth: ________________________________________________
  • Address: _____________________________________________________
  • City/Town: ___________________________ State: IA Zip: __________

Declaration

I, _________________________, being of sound mind and not under duress, fraud, or undue influence, hereby declare my desire that my dying shall not be artificially prolonged under the circumstances set forth below. This declaration reflects my firm and settled commitment to decline medical treatment that merely delays inevitable death where the prospects for recovery are nil and the treatments themselves burdensome.

Directions Concerning Life-Sustaining Procedures

In the event I suffer an incurable and irreversible condition that will result in my death within a relatively short time, I direct that the following measures be provided or withheld, according to my directions below:

  1. ____ The administration of life-sustaining treatments, including but not limited to artificial respiration, cardiopulmonary resuscitation (CPR), and artificial means of nutrition and hydration.
  2. ____ The administration of medication and other measures to alleviate pain and discomfort, even if such measures hasten my death.
  3. ____ The use of all available treatment options if there is a reasonable expectation of my recovery.

This Living Will does not affect my general right to consent to or refuse treatment unless I am in the condition described above.

Designation of Health Care Representative

I hereby designate the following individual as my representative to make health care decisions for me if I become incapable of making my own decisions:

  • Name: _________________________________________________________
  • Relationship to me: ___________________________________________
  • Address: _______________________________________________________
  • Phone Number: _________________________________________________

Alternative Representative

Should my primary representative be unavailable, unable or unwilling to make decisions for me, I designate the following individual as an alternate representative:

  • Name: _________________________________________________________
  • Relationship to me: ___________________________________________
  • Address: _______________________________________________________
  • Phone Number: _________________________________________________

Signatures

This document is intended to be legally binding and to comply with Iowa law. By signing below, I affirm that I am fully informed of the nature and effect of this document. This Living Will represents my wishes as of the date signed below.

______________________________________
Signature of the Declarant

Date: __________________________________

State of Iowa
County of ________________________________

Subscribed, sworn to and acknowledged before me by _________________________, the principal, on this ___ day of ___________, 20__.

______________________________________
Notary Public

My Commission Expires: __________________

PDF Form Information

Fact Number Detail
1 The Iowa Living Will is formally known as the "Declaration Relating to Use of Life-Sustaining Procedures."
2 It is governed by Iowa Code Chapter 144A - Life-Sustaining Procedures.
3 This document allows individuals to state their wishes regarding medical treatment if they are unable to communicate them due to a terminal condition.
4 The Living Will becomes effective when it is signed, witnessed by two adults, and the individual is unable to make their own health care decisions.
5 It permits individuals to refuse or request the withdrawal of life-sustaining procedures when they have been diagnosed with a terminal condition.
6 A terminal condition is defined as an incurable or irreversible condition for which the administration of life-sustaining procedures will only prolong the dying process.
7 The witnesses to the Living Will cannot be the individual's health care provider, an employee of the health care provider, or a relative by blood, marriage, or adoption.
8 No specific form is required by law; however, the document must clearly indicate the individual's wishes regarding life-sustaining procedures.
9 The document can be revoked at any time by the declarant, through a signed and dated written document, by orally informing the physician, or by destroying the original document.
10 Healthcare providers in Iowa are legally obligated to follow the instructions provided in a valid Living Will as long as they have knowledge of it.

How to Write Iowa Living Will

Creating a Living Will is a responsible step in planning for the future. It allows individuals in Iowa to outline their wishes regarding medical treatment if they become unable to make decisions for themselves. By completing the form accurately, one ensures that their healthcare preferences are known and respected. The process is straightforward and involves providing personal information and specifying healthcare wishes in detail.

To successfully fill out the Iowa Living Will form, follow these steps:

  1. Begin by entering your full legal name at the top of the document to identify yourself as the declarant.
  2. Specify your date of birth to provide essential identification information.
  3. Indicate your address, including city, state, and zip code, ensuring your residence is accurately documented.
  4. Move on to the section that asks about your healthcare instructions. Here, detail your desires regarding life-sustaining treatments, such as artificial nutrition and hydration, if you are in a terminal condition or a permanent coma.
  5. If you have specific wishes about pain relief, make sure to clearly articulate these preferences, even if pursuing them might extend your life.
  6. Designate a durable power of attorney for healthcare decisions by providing the name, relationship, address, and contact information of the person you trust to make health care decisions for you if you cannot make them yourself.
  7. Review the section that requires your signature. Sign and date the form in the presence of two witnesses. Ensure the witnesses are not your healthcare provider, an employee of your healthcare provider, the operator or an employee of a community care facility, or the person you have designated as your attorney-in-fact. Their signatures will also be required to validate the document.
  8. Optionally, you may choose to have the document notarized for additional legal verification. Provide it to the notary public for their signature and seal.

Upon the completion and proper execution of your Iowa Living Will form, it's recommended to share a copy with your healthcare providers, attorney-in-fact, and close family members. This ensures that your wishes are known and can be accessed by relevant parties when necessary. Remember, this document can be updated or revoked by you at any time, provided you are of sound mind.

Key Details about Iowa Living Will

What is an Iowa Living Will?

An Iowa Living Will is a legal document that allows a person to outline their preferences regarding medical treatment in the event they become unable to communicate their wishes due to illness or incapacity. It specifically addresses scenarios where terminal conditions or permanent unconsciousness are involved. This form guides healthcare providers on whether or not to administer life-sustaining treatments.

Who should have an Iowa Living Will?

Any competent adult in Iowa who wishes to have control over their medical treatment decisions should consider creating a Living Will. It's particularly important for those with strong feelings about life-sustaining measures or those with serious health conditions.

How do I create an Iowa Living Will?

To create an Iowa Living Will, you must complete a form that complies with Iowa law. The form needs to clearly state your wishes regarding life-sustaining treatment. You must sign the document in the presence of two witnesses, who also need to sign it, affirming that you are competent and acting voluntarily. Alternatively, you can have the document notarized. It is advisable to seek legal advice to ensure the form accurately reflects your wishes and meets all legal requirements.

Are there any specific requirements for the witnesses?

Yes, Iowa law has specific requirements for witnesses. Witnesses to the signing of a Living Will must be at least 18 years old. They cannot be the person creating the Living Will, related to them by blood, marriage, or adoption, entitled to any portion of the estate upon death, financially responsible for medical care, or directly involved in the provision of health care to the individual.

What should I do with my completed Iowa Living Will?

After completing your Iowa Living Will, you should provide a copy to your physician, who will include it in your medical records. It's also wise to share copies with close family members or a trusted friend, and your health care power of attorney if you have designated one. Keeping a copy in a safe but accessible place is also recommended.

Can I change or revoke my Iowa Living Will?

Yes, you can change or revoke your Iowa Living Will at any time, provided you are competent to do so. To revoke, you can either create a new Living Will that outlines different instructions, make a written declaration that you are revoking your current Living Will, or destroy the original document with the intent to revoke it. Inform your physician, family, and anyone else who has a copy that you have made changes to your wishes.

Does an Iowa Living Will cover organ donation?

An Iowa Living Will primarily focuses on decisions about life-sustaining treatment, not organ donation. If you wish to express your desires regarding organ donation, it's advisable to complete a separate document, such as a donor card or add specific instructions to a durable power of attorney for health care where you can include organ donation wishes.

Is an Iowa Living Will different from a Medical Power of Attorney?

Yes, an Iowa Living Will and a Medical Power of Attorney serve different purposes. An Iowa Living Will outlines your preferences regarding life-sustaining treatment. In contrast, a Medical Power of Attorney allows you to appoint someone to make healthcare decisions for you if you are unable to communicate your wishes. These can work together, with the Living Will guiding your attorney-in-fact in making decisions in line with your stated preferences.

What happens if I have an Iowa Living Will and I move to another state?

If you move to another state, your Iowa Living Will might still be valid, but laws vary by state. It is advisable to review the living will laws in your new state and consider updating your documents to meet the local requirements. This ensures that your healthcare wishes are respected, no matter where you reside.

Can a living will take effect if I am pregnant?

In Iowa, if you are pregnant and unable to communicate your healthcare wishes, the provisions of a Living Will may not be honored if it is determined that the fetus could develop to the point of live birth with the continuation of life-sustaining treatment. This aspect is crucial to consider when drafting a Living Will, especially for women of childbearing age.

Common mistakes

Filling out a Living Will in Iowa is an important step in planning for one's future healthcare needs. However, it's common to encounter mistakes during the process, which could potentially undermine the effectiveness of this critical document. Here’s a look at nine common mistakes people tend to make when filling out their Iowa Living Will form.

  1. Not fully understanding the document: Many people rush through filling out their Living Will without fully understanding its implications. It’s essential to comprehend what each section means and how it affects future healthcare decisions.

  2. Forgetting to update the document: Life changes such as marriage, divorce, or a shift in health status necessitate updates to your Living Will. An outdated document may not reflect your current wishes.

  3. Not discussing wishes with loved ones: Failing to communicate your healthcare preferences with family and close friends can lead to confusion and distress during emergencies. It’s critical for your loved ones to understand your desires clearly.

  4. Omitting the signature and date: An incomplete Living Will without the necessary signatures and dates is considered invalid. Make sure all required sections are duly filled out and signed.

  5. Not appointing a Power of Attorney (POA): A Living Will is crucial, but appointing a POA who can make decisions when you are unable to do so is equally important. Omitting this step can complicate healthcare decisions.

  6. Lack of specificity: Being too vague about your healthcare wishes can lead to interpretations that may not align with your true desires. It’s important to be as specific and clear as possible.

  7. Using unclear language: Given that healthcare providers will follow this document, using technical or unclear language can lead to misinterpretation. Use clear, concise language to express your wishes.

  8. Failing to witness or notarize the document: Depending on state requirements, having your document witnessed or notarized may be necessary. Neglecting this step can render the document invalid in some jurisdictions.

  9. Not having accessible copies: It’s vital to keep the Living Will in a place where it can be easily found. Moreover, providing copies to your healthcare proxy, family members, and doctor ensures everyone is informed.

To sidestep these pitfalls, take the time to understand each section of the Living Will, and don’t hesitate to seek clarification from a legal professional if needed. A well-prepared Living Will is a cornerstone of effective future healthcare planning, ensuring that your medical care aligns with your preferences under all circumstances.

Documents used along the form

When preparing a Living Will in Iowa, it's essential to consider other forms and documents that support your end-of-life wishes and health care plans. These documents complement your Living Will, ensuring comprehensive coverage of your preferences and legal requirements. This guide outlines six additional forms and documents often used alongside an Iowa Living Will.

  • Durable Power of Attorney for Health Care: This legal document allows you to appoint someone you trust (a "health care proxy") to make medical decisions on your behalf if you are unable to communicate. It's crucial because it covers health care decisions not specified in your Living Will.
  • Do Not Resuscitate (DNR) Order: A DNR order tells health care providers not to perform CPR if your heart stops or if you stop breathing. This document must be signed by a doctor and is critical for those who do not want lifesaving measures taken in certain circumstances.
  • Physician Orders for Scope of Treatment (POST): Similar to a DNR, a POST form is a doctor's order that outlines a plan of care respecting the patient's wishes regarding treatments at the end of life. It's more comprehensive than a DNR and includes preferences about the use of antibiotics, intubation, and more.
  • Medical Power of Attorney: While similar to the Durable Power of Attorney for Health Care, this document specifically allows your appointed agent to make broader health care decisions, not limited to end-of-life situations. It's especially useful in scenarios not covered by a Living Will.
  • Declaration of Guardian in the Event of Incapacity: This form allows you to choose someone to be your guardian if you become incapacitated and unable to manage your health care or financial affairs. Having this in place can avoid court-appointed guardianship proceedings.
  • Organ and Tissue Donation Registration: Registering as an organ and tissue donor can be done through your driver's license or a separate registration form. Indicating your wish to donate your organs can save lives and should be considered when planning your end-of-life care.

Each of these documents serves a specific purpose and together, they provide a comprehensive legal framework for your health care wishes. Discussing these documents with a legal professional can help you understand how they fit with your Iowa Living Will and personal circumstances. Remember, completing these documents is a significant step towards ensuring your end-of-life care is handled according to your wishes.

Similar forms

The Iowa Living Will form shares similarities with a Health Care Power of Attorney. Both documents allow individuals to make decisions about their medical treatment in advance. However, while a living will typically outlines specific wishes about life-sustaining treatment, a Health Care Power of Attorney names someone else to make health care decisions for the person, should they become unable to make decisions themselves.

Similar to an Advanced Directive, the Iowa Living Will form allows individuals to express their wishes regarding medical treatment. Both serve as a guide for medical professionals and loved ones in making healthcare decisions when the person can no longer communicate their desires. The primary difference is that advanced directives can encompass a broader range of instructions, including both living wills and durable powers of attorney for health care.

The Do Not Resuscitate (DNR) order is another document that shares commonalities with the Iowa Living Will form. A DNR specifically addresses the desire not to have CPR (cardiopulmonary resuscitation) in the event of a cardiac or respiratory arrest. While the living will can include a preference for or against CPR, a DNR is a stand-alone order recognized by medical personnel.

Durable Power of Attorney for Health Care is closely related to the Iowa Living Will form. This document appoints an agent to make healthcare decisions on behalf of the individual if they are incapacitated. While the living will specifies particular wishes about life-sustaining treatments, the durable power of attorney for health care gives someone else the authority to make broader health care decisions.

Medical Orders for Life-Sustaining Treatment (MOLST) forms also resemble the Iowa Living Will form. MOLSTs are medical orders that specify the types of life-sustaining treatment an individual wants at the end of life. While living wills express wishes generally, MOLST forms are used in medical settings to guide emergency medical personnel and other health care providers.

A Five Wishes Document is another comparable document. It goes beyond medical issues to address personal, spiritual, and emotional wishes at the end of life. Although the Iowa Living Will form focuses primarily on medical treatment and life-sustaining measures, both documents aim to ensure that the individual’s preferences are known and respected.

The Appointment of Health Care Representative form is similar to the Iowa Living Will in its function of planning for medical care decisions. This form specifically allows an individual to appoint a representative to make health care decisions on their behalf, covering a scenario where the individual may not be able to express their wishes, much like the durable power of attorney for health care.

Lastly, a Last Will and Testament, while primarily focused on the distribution of assets after death, shares a foundational purpose with the Iowa Living Will form. Both are pre-emptive legal documents that specify wishes and instructions to be carried out when the individual is no longer able to communicate or has passed away, though one focuses on health care decisions and the other on property and guardianship issues.

Dos and Don'ts

When filling out the Iowa Living Will form, it's crucial to pay attention to the details to ensure your wishes are clearly understood and legally binding. Here are essential dos and don'ts to consider:

Do:
  • Read the form carefully before starting to fill it out. This helps in understanding the requirements and ensures you provide accurate and complete information.
  • Use clear and precise language to express your health care wishes. Ambiguity could lead to misinterpretation of your intentions.
  • Sign and date the form in the presence of the required witnesses or a notary public, depending on Iowa's state laws. This step is vital for the document's legality.
  • Keep the original document in a safe but accessible place and inform your family members, health care proxy, or attorney of its location.
Don't:
  • Leave any sections incomplete. If a section does not apply, mark it accordingly to show that it was not overlooked.
  • Forget to update your living will in case of a significant change in your health condition or if you wish to alter your health care preferences.
  • Use vague terms when describing your medical care preferences. Specificity is key to ensuring your wishes are followed.
  • Fail to communicate your wishes to your family and health care providers. Having an open and honest discussion can reduce confusion and stress in difficult times.

Misconceptions

When it comes to preparing for our healthcare choices in the future, the topic of living wills often surfaces, particularly in Iowa. There are several misconceptions about the Iowa Living Will form. Understanding these misconceptions is crucial for individuals looking to make informed decisions regarding their healthcare preferences.

Here's a list of ten misconceptions about the Iowa Living Will form and explanations to clarify each point:

  1. It's only for the elderly. People often believe that living wills are only for the elderly. However, health crises can happen at any age, making a living will important for adults of all ages.
  2. It's too complicated to create. Another common myth is the complexity of creating a living will. Iowa's process is designed to be straightforward, allowing individuals to specify their health care preferences without unnecessary complexity.
  3. It's only about end-of-life care. While a living will does cover end-of-life care decisions, it also addresses other important health care preferences and interventions before a terminal phase.
  4. A lawyer is required to complete it. While legal advice can be helpful, Iowa law does not require a lawyer to fill out a living will form. Resources are available to guide individuals through the process.
  5. It takes away family's decision-making power. Some people fear that having a living will means their family will have no say in their care. However, it actually supports families by making the individual's wishes clear, reducing stress and ambiguity in difficult times.
  6. Health care providers can ignore it. There's a misconception that doctors and hospitals can easily disregard a living will. In Iowa, health care providers are legally obligated to follow the wishes outlined in a living will as much as possible.
  7. It is irrevocable. People sometimes hesitate to create a living will, thinking it cannot be changed. In fact, an Iowa Living Will can be revised or revoked by the person who created it at any time, as long as they are competent.
  8. It's expensive to create. Another misconception is the presumed high cost of creating a living will. In Iowa, individuals can create a living will without any costs, apart from potential notarization fees.
  9. It’s the same as a Durable Power of Attorney for Healthcare. Although both documents are healthcare directives and often work together, they serve different functions. A living will outlines specific treatment preferences, while a Durable Power of Attorney for Healthcare designates someone to make healthcare decisions on your behalf.
  10. It goes into effect as soon as it's signed. Some think that a living will takes effect immediately after signing. In reality, it only takes effect under the conditions specified in the document, typically upon the individual becoming unable to communicate their healthcare decisions.

Understanding these misconceptions about the Iowa Living Will form is the first step in making informed decisions about your healthcare. It's about ensuring your wishes are respected, providing peace of mind to you and your loved ones.

Key takeaways

The Iowa Living Will form is designed to help individuals communicate their wishes regarding medical treatment in the event they are unable to make decisions for themselves. Understanding how to properly complete and use this document ensures that an individual's healthcare preferences are respected and followed. Here are nine key takeaways to keep in mind:

  • Understand the document: Before completing the Iowa Living Will, it's crucial to fully understand its purpose and implications. This legal document allows individuals to outline their preferences for medical treatment if they become incapacitated.
  • Consider healthcare preferences: Individuals should carefully consider their values and preferences regarding end-of-life care, including decisions about life-prolonging treatments, resuscitation, and mechanical ventilation.
  • Consult healthcare providers: Discussing choices with a healthcare provider can clarify the medical implications of the preferences stated in the Living Will, ensuring that the document accurately reflects the individual's wishes.
  • Legal requirements: The Iowa Living Will must comply with state-specific legal requirements to be valid. These may include witnessing or notarization stipulations, so it's important to understand and follow these rules.
  • Choosing a Healthcare Power of Attorney: In addition to a Living Will, it may be beneficial to designate a Healthcare Power of Attorney (Durable Power of Attorney for Healthcare) who can make medical decisions on the individual's behalf if they are unable to communicate.
  • Communication is key: Once the form is completed, discussing the decisions made with loved ones and healthcare providers ensures that everyone is informed of the individual's wishes, reducing confusion or disagreement in the future.
  • Make it accessible: The Living Will should be kept in a place where it can be easily accessed in an emergency. Copies should be given to the individual's healthcare power of attorney, primary care physician, and included in medical records.
  • Review and update: Circumstances and preferences can change. It's advisable to review and potentially update the Living Will periodically, especially after significant life events like marriage, divorce, diagnosis of a serious illness, or the death of a loved one.
  • Support of an attorney: Though not a requirement, consulting an attorney can provide valuable guidance, ensuring that the Living Will conforms to Iowa law and accurately expresses the individual's wishes regarding medical treatment.
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