Physicians and more than 75 national organizations believe that Advance Directives are so important that recently 50 states adopted the first National Healthcare Decisions Day, which takes place on April 16.
And What is an Advance Directive?
The Patient Self-Determination Act of 1991 mandates heath care personnel to advise patients about Advance Directives, yet statistics reveal that not many patients prepare them. Advance Directives are a set of written documents that allow you to express your wishes about dying, specifically whether or not you want to accept or refuse life-sustaining treatments under specific conditions of terminal illness. Advance Directives is a plural term because two primary documents are involved. One document is called a Living Will, and the second is called a Durable Power of Attorney for Health Care (DPOA-HC). Generally, both are designed to speak for you in case you can't speak for yourself about life-sustaining medical treatment.
A Living Will is an expression of your wishes. It states whether or not you wish to receive medical interventions such as mechanical ventilation, artificial nutrition, renal dialysis, antibiotics, blood transfusions, laboratory procedures and other invasive tests to prolong your life if you become incapacitated and have little or no hope of recovery. One component of a Living Will is your choice about whether or not you desire cardio-pulmonary resuscitation if you are terminally ill and stop breathing or your heart stops beating. This component is also known as a do-not-resuscitate order, or DNR. All desires can be customized to your beliefs and preferences. By filling out a Living Will, your preferences will be known, even if you can't express them verbally when you need to. Without a Living Will in place, healthcare providers are obligated to perform heroic, life-sustaining measures in an emergency.
A DPOA-HC is a different written document, signed by you and two witnesses, naming another person (proxy) to make medical decisions on your behalf about treatments in case you cannot do so for yourself. You do not have to assign your spouse as a proxy; you may wish to ask a friend or an adult child instead. If you do not authorize a DPOA-HC, you should not assume your spouse will be called upon to make decisions on your behalf. An alternate should also be designated in case you and your proxy are both unable to make decisions.
Forms for completing all parts of Advance Directives are available from your physician, a local home health provider, a hospice and on the Internet. Be sure any Internet forms you use are approved by your state health department. Once you have signed the documents (along with two adult witnesses), give copies to your physician, family, proxy, alternate proxy and your clergyman. If you go to a hospital, bring a copy along.
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