Advance Directives: Making Crucial Healthcare Decisions Before an Emergency
No one wants to think about what would happen if heart attack, stroke, severe illness or injury were to strike. Among the many disturbing questions for such a scenario is: How will my healthcare team know my treatment preferences if I'm not able to communicate?
There are important steps you can take in advance to document your healthcare desires. A very common option is to create an advance directive.
What advance directives can do
Advance directives, also referred to as living wills, can address a number of issues, such as whether a patient wants to receive artificial respiration, dialysis, tube feeding or artificial hydration or donate an organ in the event of death. The document may also include a do-not-resuscitate order, which instructs healthcare professionals not to perform CPR if the patient stops breathing or their heart stops.
An advance directive provides a clear statement by the person of their healthcare wishes. This helps to avoid disputes that can arise among family members concerning how to treat an incapacitated relative and gives direction to healthcare professionals about the level of care to provide.
An advance directive may also include a durable power of attorney for healthcare or healthcare proxy, in which the individual names another person to make healthcare decisions for them if they are unable to do so.
However, the individual (often referred to as an advocate or surrogate) named in this document cannot make the decision to terminate life-sustaining care unless this is specified in the durable power of attorney document.
Who can create advance directives
Advance directives are available to any adult, regardless of health status. However, no one is required to create advance directives, and advance directives can be revoked at any time at the person’s request.
Before providing care, hospitals are required by law to ask people if they have an advance directive and provide guidance and necessary documents if the person chooses to create one.
If an individual is unable to make healthcare decisions and does not have an advance directive, healthcare professionals will consult with the person’s spouse, adult children, parents, siblings or other adult relatives, among others, as required by state law.
How to create advance directives
To create an advance directive, contact your healthcare professional or an area hospital. You may also want to contact an attorney, although this is not required.
Many organizations, including the National Hospice and Palliative Care Organization(link opens in new window), provide state-specific advance directive instructions and forms. Laws regarding advance directives vary from state to state.
To learn more about the laws in your state, visit the U.S. Living Will Registry website.
The National Institutes of Health also has more information on advance directives(link opens in new window).
