Medical knowledge and technology have advanced significantly in recent years, to the point where many medical interventions now are available to sustain life longer than ever before. But questions remain about what quality of life you wish to have, and those choices are very personal.
Advance directives—such as a living will and health care proxy—are legal documents that you should have in place to express your health care wishes in the event that you are unable to speak for yourself. These circumstances can occur near the end of life, but also at any time as the result of an unexpected accident, injury, or illness.
If you are seriously injured or incapacitated without these instructions in place, your family members will be in the difficult position of trying to come to consensus on decisions such as whether or not to keep you on life support, and for how long. Not only is this potentially stressful for your family members, but it may delay medical treatment while your physician tries to decide whose direction should be followed, or your family tries to obtain a necessary court order.
What is a living will?
A living will is a legal document in which you specify what medical treatments you would or would not want used to keep you alive in certain medical circumstances, such as decisions about resuscitation, tube feeding, and heart-lung machines. It also can include your wishes for pain management and organ donation.
A living will does not impact your ordinary health care decisions about medical treatment. It only takes effect when you are uncommunicative and a medical treatment may prolong your life for a limited period of time.
What is a health care proxy?
A health care proxy is a legal document that appoints a person you trust to express your wishes and make medical decisions for you when you are unable to do so.
Health care proxies can have different names in different states—other names include a “durable power of attorney,” a “durable medical power of attorney,” or a “health care surrogate.”
Even if you have a living will in place, you still should have a health care proxy. Not all medical situations can be anticipated and you never know when you may need someone you trust to make a judgment call about your health care wishes. The person you choose may be a spouse, family member, friend, or some other person you are close to and trust. It may not be your doctor or health care provider. In case the person you choose is unable to perform this duty, you may choose one or more alternates.
Requirements vary state by state, so you should prepare your advanced directives with the help of a lawyer who is familiar with your local statutes. Generally, these documents are not very costly to create, and if you are a senior citizen, your county government may provide these legal services free of charge. Check into it.
I prepared my advanced directives. What next?
Once you have prepared the advance directives, you should discuss them with your spouse, family members, and the person(s) you designated as a health care proxy to make sure everyone understands your wishes.
Keep the documents in a safe place that is easy to find, with your other important papers. Distribute a copy to your health care proxy, each of your family members, and to your primary care physician to become a part of your medical record.
When you are admitted into the hospital, give them a copy of your advance directives to go into your medical file. It’s a good idea to take a copy with you when you are traveling, and carry a wallet-sized card that lets first responders know where to find your advance directives and how to contact your health care proxy.
Nobody likes to think about these situations, but having these documents in place in the event of a serious health situation will give you and your loved ones peace of mind that your wishes will be honored.