Advance Directives

Choices regarding medical care are generally within our control. However, there may be times when we are unable to make decisions ourselves, due to illness or incapacity. Therefore, planning for when we cannot make important medical decisions is crucial.
An advance health care directive has two parts:
• The living will give family members and doctors clear guidance on the care and treatments to give.
• The health care proxy designates someone to make medical decisions for you, including whether to continue or terminate end-of-life care. Thus, the advance directive can help prevent potentially destructive disputes, ease decision-making burdens on loved ones and avoid unwanted medical procedures.
Advance directives are legally binding documents that outline our wishes regarding life support, resuscitation and other interventions to both our doctors and family members. Some people make advance directives while they are healthy. A majority do so when diagnosed with a life-threatening illness or as they age.
The physician and health care proxy are both required to follow the instructions in the living will.
The living will take effect when our attending physician determines that we are: unable to make our own medical decisions and are unlikely to regain this ability; in a persistent vegetative state; in an end-of-life condition.
In the second part, a designated health care surrogate or proxy, through a durable power of attorney for health care, makes decisions on our behalf when we can’t. This durable power of attorney for health care is given to someone who knows our wishes and is willing and able to carry them out, especially regarding our personal, spiritual, moral and cultural beliefs.
There is no legal requirement to have an advance directive. But without one, our health care decisions can be made for us by our spouse, adult child, adult sibling, parent, or a court-appointed guardian. These persons may not be aware of our wishes.
Though advance directives are legal documents, they do not have to be written by a lawyer. But, it is a good idea to consult one on how to tailor an advance directive that best expresses our wishes.
Discuss the advance directive with your designated health care proxy, so the person understands clearly what you want.
Our signature must be affixed to the advance directive, dated and witnessed by two others who are not our doctors, who are unrelated to us and do not expect an inheritance.
Advance directives can be canceled or changed at any time. Changes should be written, signed, witnessed and dated. It is actually a good idea to review the directive periodically. If changes are made, be sure to provide the primary doctor and health care proxy and immediate family with a copy of the revised document.
Planning for the future is never easy. However, advance directives ensure that our wishes are carried out when we are unable to make sound decisions about our health care and create peace of mind for ourselves and our loved ones.