What is an Advance Directive?

Advance Directives direct medical treatment when you are impaired

An Advance Directive or Living Will is a legal document in which you tell medical professionals what treatments you want or do not want given to you in the event that you are incapacitated and need treatment.  This document should be filled out by anyone over 18 years of age.  It takes effect if you are in a near death experience where withholding treatment could cause your death.  If there is an accident, parents cannot advocate for a child over 18 years and a wife or husband cannot advocate for their spouse without it.  An attorney can fill it out for you and on National Health Care Decisions Day each year, many attorneys volunteer their time to help you fill one out.

Why do you need one?  After age 18, you are considered capable of making your own decisions about your healthcare.  What if you are in an accident and not expected to live?  Do you want doctor’s to go to extreme measures to keep you alive just because they can?  That response may depend on your age.  The older a person is, the less likely they are to want extreme measures commenced, especially if they have multiple conditions.  As conditions deteriorate, the patient needs to have spelled out exactly what they want given in the way of medical treatments, food and hydration.  This may take the burden off the family who tries to determine what you would have wanted.  It also avoids litigation if there is disagreement over what someone thinks you might have wanted.

If you go into sudden cardiac arrest, an EMS professional will be required to do CPR unless you have the legal document handy which specifies you do not want to be resuscitated (DNR). The Patient Determination Act went into law in 1991 requiring every nursing facility, hospital, home health agency, hospices, and prepaid health care organizations to know what you want to be done.  The Advance Directive or Living Will document copy should be given immediately to the hospital personnel, nursing home or other facility responsible for your care.  If you do not have one, most organizations will have you fill one out upon arrival at their facility.  However, if you are not conscious, you will not be able to fill one out.  Two witnesses are required to sign the directive.  Give a copy of the living will or advance directive to a family member, doctor, power of attorney and attorney.

Decisions covered in an Advance Directive

Some of the issues covered in and advance directive or living will include:

  • Surgery or other invasive procedures
  • Cardiopulmonary resuscitation (CPR) to restart your heart or breathing
  • Antibiotics
  • Dialysis
  • Mechanical ventilator (respirator)
  • Artificially supplied nutrition and hydration (including tube feeding)
  • Chemotherapy
  • Radiation therapy
  • All other “life-prolonging” medical treatments or surgeries that are merely intended to keep you alive without reasonable hope of making you better or curing your illness or injury.
  • Pain Management (What kind of pain are you willing to tolerate?)

You are also given an opportunity to donate your organs. Most State Attorney General offices have forms and/or booklets explaining what each item means.

In summary, an Advance Directive or Living Will spells out your healthcare decisions in the event that you are unconscious and face near death unless medical treatment is begun.  This document should be given to all people and institutions that may offer treatment and it should be handy in the occasion that you go to the hospital.

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