At one second after midnight on an individual’s eighteenth birthday is a good place to start.  Another good place is when someone buys a home, gets married, or has a child.
A fallout of not having one is what happened to Terry Schiavo in Florida while she was still living. A legal battle ran for years with her husband saying she never wanted to live in a persistent vegetative state while her parents argued all the way to the Florida Supreme Court that her condition wasn’t in the state her husband claimed and she should be kept alive.

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