Patient Information About Advance Directives
An Advanced Directive could be a Living Will or a Durable Power of Attorney for health care — either document allows you to give directions about your future medical care.
When considering Advance Directives in your health care planning, know your rights and take steps to protect them. Discuss your wishes with your family and physician and review your Advance Directives and make sure they express your wishes clearly.
It’s your right to accept or refuse medical care. Advance Directives can protect this right if you ever become mentally or physically unable to choose or communicate your wishes due to an injury or illness.
The following is a list of reasons why you need to learn more about how Advance Directives can be a valuable
tool to you:
1. They can protect your rights to make medical choices that can affect your life.
2. They allow your family to avoid the responsibility and stress of making difficult decisions.
3. They allow you to provide direction to your physician by establishing guidelines for your care.
Advance Directives can protect people in extreme conditions such as: irreversible brain damage or brain disease, which can affect their ability to think as well as communicate; a permanent coma (or other unconscious states), which can leave a person without hope of recovery; or terminal illness, which you are expected to die within a short period of time (terminal illnesses may lead to brain damage and loss of consciousness).
Below are some statements, which you could consider when drafting an Advance Directive:
1. It is important for me to:
- Die without pain or suffering
- Be able to make my own decisions
- Leave my family with good memories
- Not burden my family with difficult decisions
- Act according to my religious beliefs
- Be with my loved one at death
2. Also consider the medical possibilities:
- Being in a coma or other unconscious state
- Having permanent brain damage
- Being terminally ill
3. Finally, ask yourself which of these statements best describes your feelings:
- It is important to me to prolong life, regardless of pain, if my chances for recovery are good and cost is not a factor; or
- I prefer not to prolong my life if the chances for recovery are not good and cost is a factor.
You should also discuss your responses with family and friends, your physician, clergy, and your lawyer.
4. Advance Directives can limit life-prolonging measures when there is little or no chance of recovery.
For example, Advance Directives may enable patients to make their feelings known about:
- Cardiopulmonary Resuscitation (CPR) — used to restore stopped breathing and/or heartbeat.
- Intravenous (IV) Therapy — used to provide food, water and/or medication through a tube placed in a vein when patients can no longer eat or drink normally.
- Feeding Tubes — inserted through the nose or throat to provide nutrition when patients can no longer eat normally.
- Respirators — machines used to keep patients breathing.
- Dialysis — a method of cleaning patients’ blood by machine when kidneys no longer work properly.
- Pain Relief — either requesting or refusing it.
5. Some special issues you may want to consider are:
- DO NOT RESUSCITATE (DNR) Orders — a DNR order allows you to refuse attempts to restore heartbeat. Discuss this option with your physician.
- ORGAN DONATION — Advance Directives can state your wishes to donate specific organs (or your entire body).
- SPECIAL TREATMENTS AND PROCEDURES — in addition to pain control, you may request or refuse tube feeding and other medical procedures.
6. There are two types of Advance Directives:
a. Living Wills — These are written instructions that explain your wishes regarding health care should you
have a terminal condition. They are called “living wills” because they take effect while a patient is still alive.
b. Durable Power of Attorney — In a written document, you can name a person (called a proxy) to make decisions for you if you become unable to do so.
In order to create Advance Directives you should check the laws in your State regarding Living Wills and Durable Power of Attorneys. Put your wishes in writing and be as specific as possible (forms may be available from the sources listed below). Make sure you sign and date your Advance Directive and have them witnessed and notarized. If necessary, in your State, keep a card in your wallet stating you have an Advanced Directive and where to find them. Give your physician a copy to be kept as party of your medical record; discuss your Advance Directive with family and friends; and give copies to a relative or friend who is likely to be notified in an emergency.
Review your Advance Directive regularly and make any necessary changes. Inform your physician, family and proxy of any changes.
7. Help and information are available. If you need help in preparing Advanced Directives or if you would like
more information, contact:
- A lawyer
- Hospitals, Hospices, Home Health Agencies and Long Term Care Facilities
- Your State Attorney General’s Office
- Choice in Dying, 200 Varick St., New York, NY 10014
