The idea was originally thought up in 1967 by two groups, the Euthanasia Society of America and Euthanasia Education Council, who had been trying for years to get mercy killing bills passed in various states (Valko, 2004). They saw the living will as a new strategy of incremental approach. The Euthanasia Society of America changed its name to the Society for the Right to Die, and the Euthanasia Education Council became the Concern for Dying. In the 1990s, the two groups formally merged and became known as the Choice in Dying.
The first living wills were simple declarations that if a patient became terminally ill and unable to make medical decisions for themselves, their doctors were directed to withhold or withdraw medical treatment that prolongs the dying process and is not necessary to relieve pain or provide comfort (Valko, 2004). California became the first state to legalize living wills in 1976 as the California Natural Death Act. In Missouri, pro-life advocates saw court cases involving the removal of feeding tubes from non-dying brain-injured people in vegetative states, and feared the living will would allow passive euthanasia. Right to die advocates in Missouri denied this and to ensure passage of the living will bill, a provision was added which added that food and water could not be withdrawn, but this provision was soon dropped.