Advance Directives
What are advance directives?
"Advance directive" is a general term that describes two types of legal documents:
- Living wills
- Medical power of attorney
These documents allow you to instruct others about your future medical care wishes and appoint a person to make healthcare decisions if you are not able to speak for yourself. Each state regulates the use of advance directives differently.
What is a living will?
A living will is a type of advance directive in which you put in writing your wishes about medical treatment for the end of your life in the event you cannot communicate these wishes directly. Different states name this document differently: for example, it may be called a "directive to physicians," "health care declaration," or "medical directive." Regardless of what it is called, its purpose is to guide your family and doctors in deciding about the use of medical treatments when you are dying.
Your legal right to accept or refuse treatment is protected by the Constitution and case law. However, your state law may define when the living will goes into effect, and may limit the treatments to which the living will applies. You should read your state's suggested document carefully to ensure that it reflects your wishes. You can add further instructions or write your own living will to cover situations that the state suggested document might not address. Even if your state does not have a living will law, it is wise to put your wishes about the use of life-sustaining medical treatments in writing.
What is a medical power of attorney?
A medical power of attorney is a document that lets you appoint someone you trust to make decisions about your medical care if you cannot make them yourself.
This type of advance directive can also be called a "healthcare proxy," "appointment of a healthcare agent," or "durable power of attorney for healthcare." The person you appoint may be called your healthcare agent, surrogate, attorney-in-fact, or healthcare proxy. The person you appoint through a medical power of attorney usually is authorized to deal with all medical situations, not only end-of-life decisions when you cannot speak for yourself. Thus, he or she can speak for you if you become temporarily incapacitated-after an accident, for example-as well as if you become incapacitated because of irreversible disease or injury.
Generally, the law requires your agent to make the same medical decisions that you would have made, if possible. To help your agent do this, it is essential that you discuss your values about the quality of life that is important to you and the kinds of decisions you would make in various situations. For example, how aggressively would you want medical treatments supplied if you had Alzheimer's disease or if you were in a coma and unlikely to recover? Share your thoughts concerning someone you have known who was very ill and how you would want to be treated if you were in a similar situation. These discussions will help your agent to form a picture of your views regarding the use of medical treatments.
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