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Advance Directives

What They Are And What They Do

What is a medical power of attorney? continued...

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.

If this discussion does not take place, your agent will have to examine any general statements you might have made, your religious and moral beliefs, and what he or she knows about your values in general. When your wishes about a particular medical decision are not known your agent must act in your best interest, using his or her own judgment depending on your state's law.

Some states let you appoint an agent within the living will. This is different from a medical power of attorney, because an agent appointed in a living will can only make decisions about using medical treatments, and only if you are in one of the medical conditions specified in your state's law (such as "terminally ill," "permanently unconscious," or "imminently dying").

Why do I need advance directives?

Advance directives give you a voice in decisions about your medical treatment, even if you are unconscious or too ill to communicate.

As long as you are able to make and express your own decisions, you can accept or refuse any medical treatment. But if you become seriously ill, you might lose the ability to participate in decisions about your own treatment.

Research has shown that 80 percent of us now die in a medical facility such as a hospital or nursing home, as medical technology can now prolong life as never before. The quality of that life, however, may be greatly reduced. As a result, many patients, families and caregivers face difficult questions about how much technology to use when the patient cannot get better. That means most of us will face a decision about whether to use life-sustaining treatments at the end of our lives. If we cannot speak for ourselves at that point, other people will have to make the decisions for us.

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