Advance Medical Directive

An Advance Medical Directive is also known as a “Living Will”. This document states your preferences for medical treatment if you are incapable of making an informed decision and you are in a terminal condition, such as an irreversible coma.

Your declaration in advance of a terminal condition, when properly drafted, provides assurance that you will only receive the level of care that you specified in the document, and that you will not receive life-prolonging procedures if you do not wish to. This document may reduce family stress and conflict during this difficult time, and more importantly, minimize your suffering.

After life-prolonging procedures have been withdrawn, you may wish to continue to receive medication and medical procedures deemed necessary to alleviate pain or provide comfort care. You may also state that neither artificially administered hydration nor nutrition should be used to prolong life, but one or both may be provided to alleviate pain or provide comfort care.

No Advance Medical Directive

This is analogous to having no Will; state statutes will determine who will make medical decisions for you.  That person is called a surrogate.  Surrogates are generally designated to make medical decisions for you in the following order, depending on state law:

  1. Court appointed guardian
  2. Spouse, except where divorce is pending
  3. Adult child
  4. Parent
  5. Adult sibling
  6. Other relative in descending order of blood relationship

The persons designated as surrogates by state statutes may not be those who are best informed regarding your treatment preferences.  Also, persons in the same class, such as adult children, or in a different class, such as adult children and a spouse, may disagree as to a course of action, resulting in conflict and bad feelings.

An agent granted authority under an Advance Medical Directive has all the authority to make health-care decisions that you yourself would have, and has priority over any other person to act for you in health care matters.  Having an agent that you appoint under your document as opposed to a surrogate helps to insure that your treatment preferences will be respected and to overcome challenges to health care decisions.

 

Health Care Power of Attorney

A Health Care Power of Attorney designates an agent to make health care decisions for you in the event that you cannot make an informed decision, which may not be related to a terminal condition.

In order to further insure that your treatment preferences will be respected, you should:

  1. Provide your primary care physician or hospital with a copy of your Advance Medical Directive/Health Care Power of Attorney; and
  2. Discuss your preferences in advance of treatment with your agent and your doctor.

 

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