Crisis Planning: Legal/Medical Stuff
Jun. 9th, 2025 02:05 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
lb_leeCrisis Planning: Legal Stuff: Wills, Organ/Body Donations, and DNR/MOLST/POLST Forms
Series: Essay (Crisis Planning)
Summary: A guide to living wills, health care agents, organ/body donations, and DNR/MOLST/POLST forms (i.e., how to make sure you get the care you want and not the stuff you don't when you're unable to make your desires known).
Notes: Winner of the fan poll this month! If you want to support my work, join LiberaPay or Patreon and get double-weight for your votes. Also, these crisis plan essays have proven so popular (and regrettably necessary) that we have made a whole ebook of them up for sale for $5 here.
Nobody likes to think about this stuff, but seriously, think it over, especially if any of the following is a concern of yours:
• Ending up under the care of your abusers if medically incapacitated.
• Being denied medical care you need, leading to your “merciful” death.
• Making sure your loved ones know what to do if you’re in a coma.
• Donating your body to science.
The Living Will
The Five Wishes is an easy-to-understand, simple-to-fill-out ten page will (with wallet cards) that is acceptable in all fifty states (though some need extra steps). It’s what we used and we recommend it to anyone. You can buy paper or digital copies online at a reasonable price; we ourself found a copy at a local church and just took it home. Among the things it covers:
• Health Care Agents: choosing three people who can make healthcare decisions for you when you no longer can (say, you’re in a coma).
• Life support and medical treatment you want given to you if you’re incapacitated: what kind, and under what circumstances. (It also gives advice regarding a Do Not Resuscitate/MOLST/POLST order; more on that later.)
• How you want to be treated when dying.
• Stuff you want your loved ones to know.
• Memorial service preferences.
You will need two witnesses (who are not in your Health Care Agent line or able to benefit in any way from your will—I chose a couple friends) to sign off saying they saw you sign the will and that you weren’t being coerced or in unsound mind. For most states, that’s enough, but Missouri requires your signature be notarized, while North and South Carolina and West Virginia require both your signature and your witnesses’ signatures be notarized. Wisconsin also requires a special Wisconsin statement, and if you’re institutionalized in California, Connecticut, Delaware, Georgia, New York, North Dakota, South Carolina, or Vermont, there are special witnessing rules.
Making a living will can be a stressful, challenging experience. (There’s a reason we called the Five Wishes simple to fill out, rather than easy.) It requires thinking hard about one’s health and death. Do it early, and take it slowly; it took us something like three years to complete it, just because we had a lot of feelings to work out, decisions to make, and people to talk about them with.
DNR/MOLST/POLST forms
People are more familiar with DNR (Do Not Resuscitate) stuff, but it’s actually not as flexible as a MOLST (Medical Orders for Life-Sustaining Treatment) or a POLST (Physician Orders for Life-Sustaining Treatment). We did both a MOLST and a DNR, but a MOLST/POLST should cover your bases fine.
A DNR is only one page long, and it’s just what it sounds like: if you flat-line in the hospital, it’s the order to let you go. That’s it. That’s all it does.
A MOLST/POLST, however, does more! (And is used in more states, so like I said, go for those first. Massachusetts is in the middle of transitioning from MOLST to POLST; see citations for current link.) It covers what treatment you do and don’t want (CPR, ventilation, transfer to hospital, intubation, ventilation, dialysis, artificial nutrition and hydration, etc.). These forms are useful not just for weird death-critters like us, but for anyone who wants very much to stay alive and has reason to worry their doctors don’t agree (say, certain disabled people). If you’re the kind of person who worries about being “mercy-killed” against your wishes, these forms are what you want!
All three of these types of forms need your doctor to sign off and approve it. That’s the tricky part, approaching your doctor (especially if you are comparatively young and healthy) and trying to persuade them you’re a competent adult capable of making such grim decisions so far in advance. We were extremely nervous about it, took years to summon the courage… and to our surprise and relief, our doctor was delighted we were being so proactive in our health planning! She happily gave us all the information she thought we might need, then signed off and stored the forms. Phew! However, this does mean we don’t have decent advice as to what to do if your doctor just won’t cooperate, short of, “change doctors,” which is far easier to say than do.
These papers come in the big form (stored by your doctor and yourself and also whoever you want—like your Health Care Agents, or your Hit-By-A-Bus Crisis Plan email circle!), and also wallet cards to laminate.
Organ/Body Donation
Donating your body or organs to posterity can be a really nice thing to do! Besides organs being given to people who need them (kidneys are always in short supply), medical donations also help train medical students, give forensic knowledge, and test safety equipment (and also weaponry).
Signing yourself up to be a posthumous organ donor is surprisingly easy, at least in our home state of Massachusetts! Next time you update your driver’s license, you can just check a box saying you want to be an organ donor! From then on out, your driver’s license will have a little pink heart with the word “donor” on it. Easy. (Different states may have different rules. Sorry, but we’re not researching 49 other state regulations for a zine.) Since we’re still in pretty good shape from the collarbone down, we would be happy to know that even after we ourself die, our organs might survive longer and in the process keep other people alive!
Donating your whole body (for med student practice, for forensics stuff, for ballistics testing…) is a little trickier. We used MedCure; there are three pages of forms that were pretty easy to fill out, though again you need two witnesses. Not sure how well that’ll work out for us, and alas, we will be unable to tell you.
Some people have a strong, visceral horror reaction to the idea of donating their body or organs after death. If you’re one of them, there’s no shame in that; go ahead and do cremation or burial or whatever you’d normally do. However, if you want to be able to donate body and organs to posterity and find your own squick a hindrance… we apparently once managed to accidentally comfort a few random Internet strangers with our silly serious-joking about how we looked forward to our corpse merrily having “deadventures” even after we had left the building. Our corpse could help improve the designs for seat belts, hardhats, or bulletproof vests! It could train a doctor! It could do all sorts of things that wouldn’t be possible while still alive, and we like to imagine it’d have fun doing them.
Also, it’s a grim comfort to think that even if we do go catastrophically batshit and commit suicide prematurely, our comparatively young, healthy body might still continue committing acts of service.
We hope you never need the details of this plan. If you do, we hope they serve you well.
Citations
Aging With Dignity. Five Wishes. Accessed June 7, 2025, from https://store.fivewishes.org/ShopLocal/en/p/FW-MASTER-000/five-wishes-advance-directive
Commonwealth of Massachusetts Department of Public Health. “Massachusetts Medical Orders for Life-Sustaining Treatment.” 2013. Accessed June 7, 2025 from https://www.mass.gov/doc/sample-molst-form/download
Dementia Directive. 2017. Accessed May 6, 2025 from https://www.dementia-directive.org
the Icarus Project. “Navigating Crisis.” Accessed May 28, 2025, from https://fireweedcollective.org/wp-content/uploads/2020/03/IcarusNavigatingCrisisHandoutLarge05-09.pdf
Medcure. Body Donation to Support Medical Science. Accessed June 7, 2025 from https://ww.medcure.org
Series: Essay (Crisis Planning)
Summary: A guide to living wills, health care agents, organ/body donations, and DNR/MOLST/POLST forms (i.e., how to make sure you get the care you want and not the stuff you don't when you're unable to make your desires known).
Notes: Winner of the fan poll this month! If you want to support my work, join LiberaPay or Patreon and get double-weight for your votes. Also, these crisis plan essays have proven so popular (and regrettably necessary) that we have made a whole ebook of them up for sale for $5 here.
Nobody likes to think about this stuff, but seriously, think it over, especially if any of the following is a concern of yours:
• Ending up under the care of your abusers if medically incapacitated.
• Being denied medical care you need, leading to your “merciful” death.
• Making sure your loved ones know what to do if you’re in a coma.
• Donating your body to science.
The Living Will
The Five Wishes is an easy-to-understand, simple-to-fill-out ten page will (with wallet cards) that is acceptable in all fifty states (though some need extra steps). It’s what we used and we recommend it to anyone. You can buy paper or digital copies online at a reasonable price; we ourself found a copy at a local church and just took it home. Among the things it covers:
• Health Care Agents: choosing three people who can make healthcare decisions for you when you no longer can (say, you’re in a coma).
• Life support and medical treatment you want given to you if you’re incapacitated: what kind, and under what circumstances. (It also gives advice regarding a Do Not Resuscitate/MOLST/POLST order; more on that later.)
• How you want to be treated when dying.
• Stuff you want your loved ones to know.
• Memorial service preferences.
You will need two witnesses (who are not in your Health Care Agent line or able to benefit in any way from your will—I chose a couple friends) to sign off saying they saw you sign the will and that you weren’t being coerced or in unsound mind. For most states, that’s enough, but Missouri requires your signature be notarized, while North and South Carolina and West Virginia require both your signature and your witnesses’ signatures be notarized. Wisconsin also requires a special Wisconsin statement, and if you’re institutionalized in California, Connecticut, Delaware, Georgia, New York, North Dakota, South Carolina, or Vermont, there are special witnessing rules.
Making a living will can be a stressful, challenging experience. (There’s a reason we called the Five Wishes simple to fill out, rather than easy.) It requires thinking hard about one’s health and death. Do it early, and take it slowly; it took us something like three years to complete it, just because we had a lot of feelings to work out, decisions to make, and people to talk about them with.
DNR/MOLST/POLST forms
People are more familiar with DNR (Do Not Resuscitate) stuff, but it’s actually not as flexible as a MOLST (Medical Orders for Life-Sustaining Treatment) or a POLST (Physician Orders for Life-Sustaining Treatment). We did both a MOLST and a DNR, but a MOLST/POLST should cover your bases fine.
A DNR is only one page long, and it’s just what it sounds like: if you flat-line in the hospital, it’s the order to let you go. That’s it. That’s all it does.
A MOLST/POLST, however, does more! (And is used in more states, so like I said, go for those first. Massachusetts is in the middle of transitioning from MOLST to POLST; see citations for current link.) It covers what treatment you do and don’t want (CPR, ventilation, transfer to hospital, intubation, ventilation, dialysis, artificial nutrition and hydration, etc.). These forms are useful not just for weird death-critters like us, but for anyone who wants very much to stay alive and has reason to worry their doctors don’t agree (say, certain disabled people). If you’re the kind of person who worries about being “mercy-killed” against your wishes, these forms are what you want!
All three of these types of forms need your doctor to sign off and approve it. That’s the tricky part, approaching your doctor (especially if you are comparatively young and healthy) and trying to persuade them you’re a competent adult capable of making such grim decisions so far in advance. We were extremely nervous about it, took years to summon the courage… and to our surprise and relief, our doctor was delighted we were being so proactive in our health planning! She happily gave us all the information she thought we might need, then signed off and stored the forms. Phew! However, this does mean we don’t have decent advice as to what to do if your doctor just won’t cooperate, short of, “change doctors,” which is far easier to say than do.
These papers come in the big form (stored by your doctor and yourself and also whoever you want—like your Health Care Agents, or your Hit-By-A-Bus Crisis Plan email circle!), and also wallet cards to laminate.
Organ/Body Donation
Donating your body or organs to posterity can be a really nice thing to do! Besides organs being given to people who need them (kidneys are always in short supply), medical donations also help train medical students, give forensic knowledge, and test safety equipment (and also weaponry).
Signing yourself up to be a posthumous organ donor is surprisingly easy, at least in our home state of Massachusetts! Next time you update your driver’s license, you can just check a box saying you want to be an organ donor! From then on out, your driver’s license will have a little pink heart with the word “donor” on it. Easy. (Different states may have different rules. Sorry, but we’re not researching 49 other state regulations for a zine.) Since we’re still in pretty good shape from the collarbone down, we would be happy to know that even after we ourself die, our organs might survive longer and in the process keep other people alive!
Donating your whole body (for med student practice, for forensics stuff, for ballistics testing…) is a little trickier. We used MedCure; there are three pages of forms that were pretty easy to fill out, though again you need two witnesses. Not sure how well that’ll work out for us, and alas, we will be unable to tell you.
Some people have a strong, visceral horror reaction to the idea of donating their body or organs after death. If you’re one of them, there’s no shame in that; go ahead and do cremation or burial or whatever you’d normally do. However, if you want to be able to donate body and organs to posterity and find your own squick a hindrance… we apparently once managed to accidentally comfort a few random Internet strangers with our silly serious-joking about how we looked forward to our corpse merrily having “deadventures” even after we had left the building. Our corpse could help improve the designs for seat belts, hardhats, or bulletproof vests! It could train a doctor! It could do all sorts of things that wouldn’t be possible while still alive, and we like to imagine it’d have fun doing them.
Also, it’s a grim comfort to think that even if we do go catastrophically batshit and commit suicide prematurely, our comparatively young, healthy body might still continue committing acts of service.
We hope you never need the details of this plan. If you do, we hope they serve you well.
Citations
Aging With Dignity. Five Wishes. Accessed June 7, 2025, from https://store.fivewishes.org/ShopLocal/en/p/FW-MASTER-000/five-wishes-advance-directive
Commonwealth of Massachusetts Department of Public Health. “Massachusetts Medical Orders for Life-Sustaining Treatment.” 2013. Accessed June 7, 2025 from https://www.mass.gov/doc/sample-molst-form/download
Dementia Directive. 2017. Accessed May 6, 2025 from https://www.dementia-directive.org
the Icarus Project. “Navigating Crisis.” Accessed May 28, 2025, from https://fireweedcollective.org/wp-content/uploads/2020/03/IcarusNavigatingCrisisHandoutLarge05-09.pdf
Medcure. Body Donation to Support Medical Science. Accessed June 7, 2025 from https://ww.medcure.org
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