WebMD Medical Reference from the National Hospice and Palliative Care Organization
What are advance directives?
"Advance directive" is a general term that describes two types of
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
When it comes to reducing your hospital risks, questions are key. "Most
patients simply don't ask enough questions," says Carolyn Clancy, MD,
director of the Agency for Healthcare Research and Quality (AHRQ) in Rockville,
Md. "But the enlightened minority who do ask questions in the hospital have
a greater sense of control over their health -- and they just do
You should start asking questions about your hospital risks long before you
check in. Next time you see your doctor -- or...
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
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.