The living will is the oldest form of advance directive. It was first proposed by an Illinois attorney, Luis Kutner, in a law journal in 1969. Kutner drew from existing estate law, by which an individual can control property affairs after death and devised a way for an individual to express his or her health care desires when no longer able to express current health care wishes. Because this form of “will” was to be used while an individual was still alive (but no longer able to make decisions) it was dubbed¹ the “living will.”

 

Living will（生前预嘱）是预立医疗指示（advance directive）最早的形式，最初由伊利诺伊州一位名叫路易斯·库特纳的律师在1969年的一份法律期刊上提出。现行的财产法允许个人对身故后的财产事务提前做好安排，库特纳从中获得灵感提出了让个人提前表明在身体无法自主时想要得到的医疗护理要求。因为这种“嘱愿”要在个人活着（但无法做决定）的时候使用，所以被称为“生前预嘱”。

 

The living will is used only if the individual has become unable to give informed consent or refusal due to incapacity. A living will can be very specific or very general. An example of a statement sometimes found in a living will is: “If I suffer an incurable², irreversible illness, disease, or condition and my attending physician determines that my condition is terminal, I direct that life-sustaining measures that would serve only to prolong my dying be withheld³ or discontinued.”

 

生前预嘱只能在个人无法做出知情同意或否决的决定时使用。预嘱可以很具体也可以很宽泛。会被写入预嘱的声明可能会是这样的：“如果我患了不治之症或处于无力回天的境地，而我的医生也认为我的情况无法挽回，我要求禁用或停用那些只会延长我死亡进程的生命维持手段。”

 

Living wills proved to be very popular, and by 2007, 41% of Americans had completed a living will. In response to public needs, state legislatures soon passed laws in support of living wills in virtually every state in the union.

 

生前预嘱受到普遍认可，到2007年，已有41%的美国人立了生前预嘱。为了回应公众需求，美国各州的立法部门在短时间内基本都通过了支持生前预嘱的法案。

 

Living wills reflect a moment in time, and may therefore need regular updating to ensure that the correct course of action can be chosen.

 

生前预嘱只能反应某个时间段的状态，因此需要定期更新以确保做出正确的指令选择。

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