Making Your Last Wishes Known
July 7, 2000 -- Laws in every state have made it clear: You have the
fundamental right to make a decision in advance about whether to accept or
refuse medical treatment if you become gravely ill. You can exercise this right
through an advance directive, a legal document that provides clear directions
to physicians and caregivers about how you wish to be treated should you become
unable to communicate.
According to a 1991 Gallup poll, 75% of Americans feel advance directives
are a good idea, yet only 20% actually complete them. By taking the steps to
prepare an advance directive before a medical crisis arises, you can make
decisions thoughtfully and ensure that your wishes concerning end-of-life
treatment will be honored. And remember: These directives are not just for the
elderly. Illness and accidents in particular befall younger people as well.
There are two main kinds of advance directives:
- A living will tells your health care providers what kind of medical care
you want to receive -- or have withheld -- if you become critically ill and are
unable to communicate your wishes. It can contain general statements of
philosophy as well as more specific instructions detailing your desires under
- A medical power of attorney, or proxy, names another trusted person as a
decision-maker for you if you become unable to make your own decisions.
Requirements for advance directives vary from state to state, so it's
important to check before you write one. You can use a lawyer to help you draft
your directive or do it on your own. You can obtain free, state-specific,
do-it-yourself forms from Partnership for Caring, a nonprofit group that
invented the living will in 1967 and counsels people about end-of-life issues.
You can reach them at 1-800-989-9455 or online at http://www.partnershipforcaring.org.
Be certain to have your directive witnessed or notarized, or both, according
to your state law. Keep the original in your personal files and give copies to
your family members, any proxy, and all your physicians. Ask your doctors to
have it placed in your permanent medical record. And keep a card in your purse
or wallet naming your proxy and indicating that you have an advance directive
and where it can be found. If you haven't written an advance directive and are
hospitalized, you should know that hospitals are supposed to ask you if you
want to write one and should also allow you to enter a do-not-resuscitate (DNR)
order into your medical record.
Make sure you discuss your wishes with your doctors, proxy, and family
members -- in part so they won't try to contradict your instructions later.
"The completion of a health care directive doesn't end when you sign the
document and put it in a drawer," says Carol Sieger, staff attorney with
Partnership for Caring. "Paint a picture about what's acceptable and not
acceptable, what your personal values are, your idea of independence. What are
your wishes regarding care? What do you view as quality of life? "