Your Advance Directive for Healthcare Explained
An advance directive for health care is a document that allows you to make decisions about your health care today in the event you become unconscious and unable to communicate those decisions tomorrow. Each state has its own laws that prescribe the form of the document. Most states refer to this document as an “advance directive for health care." Other descriptions include “living will,” “health care proxy,” and “health care power of attorney.” The differences in laws among the states results in documents with varying formatting or ordering of the information. Despite the document's appearance, an advance directive generally consists of four or five main sections.
Living Will
This section contemplates two major health care scenarios: terminal illness or injury, and permanent unconsciousness.
A terminal injury or illness is one which your doctor has determined cannot be cured and you will likely die in the near future from this condition.
Permanent unconsciousness is a condition which your doctor and another doctor both agree that within a reasonable degree of medical certainty you can no longer think, feel anything, normally move, or be aware of being alive. The doctors must believe the condition will last indefinitely without hope for improvement.
Remember that neither of these diagnoses are made by doctors without extensive tests.
Also remember that as long as you are conscious and able, you can make your own health care decisions. This document comes into effect only when you are so gravely ill, that you're unable to communicate and make health care decisions for yourself.
Decisions
Within these two events or scenarios, terminal illness and permanent unconsciousness, there are two choices that you get to make.
The first is, do you want artificially provided food and water? This means that you will receive food and water through a tube or IV.
The second is, do you want continued treatment. This means that you will receive drugs and medical treatment to keep you alive, but not cure you. These two choices are available for each of the two health care events.
Health Care Proxy or Health Care Power of Attorney
The advance directive allows you to appoint a trusted individual, such as a spouse, family member or trusted friend to make certain decisions regarding your health care. This person is called a health care proxy or health care power of attorney You don't have to have a proxy, but if you do you can give them three different levels of decision-making authority.
Level One
With level one authority you are directing your health care proxy to follow all of your instructions in this document to the letter. You’re counting on them to be your advocate and to make sure that everything that you are saying in this document is carried out.
Level Two
Level two authority is basically unlimited. You're saying, "Health care proxy, I told you what I want to do in this document. If however, you think that decisions should be made otherwise, I'm giving you the authority to make a decision that is different from what I have indicated."
Level Three
The third level of authority is something in the middle. Basically, you're saying, "Health care proxy, I want you to follow the letter of this document. If, however, there are certain circumstances that arise that this document does not contemplate, then I leave it to you to make the decision."
It's important to understand the role of your health care proxy and the three different types of powers that you can give this person prior to completing the advanced health care directive.
Organ Donation
This section is an opportunity for you to indicate whether or not you want to donate your organs.
Primary Physician
Some states include an optional section that allows you to designate a physician as your primary physician.
Signing the Documents
The advance directive must be signed by you and witnessed by two people who are not related to you and would have no opportunity to inherit anything from you. This is designed to keep people from having a conflict of interest on whether to keep you alive or not. In some states, a notary public can sign instead of two witnesses.
The persons you nominate as your first and second choice health care proxy/power of attorney must also sign the document, but their signature does not typically require a notary acknowledgement.
Make sure trusted friends or someone other than your family members witness your signing of this document.
It’s Important to note, this document won’t do its job sitting at the bottom of a drawer. The next time you go to your doctor, take a copy of this document with you and have them add it into your medical records.
That’s part of prudent planning to ensure your plan works for you.