4 Things an Advance Directive Should Address
Living wills are common advance directives that address medical decisions related to end of life and can address issues in the following categories:
- The types of treatment you would either want or not want to receive
- Under what conditions you want attempts to prolong your life to begin or end
The kinds of treatments commonly addressed include dialysis, tube feeding, and life support, such as the use of breathing machines.
Medical Power of Attorney
A medical power of attorney (POA) is a legal document that addresses the matter of who will make medical decisions on your behalf in the event that you are unable to do so. In your medical POA, the person to whom you assign this hefty responsibility is known as the attorney-in-fact (or agent).
One: Whom You Want to Make Your Healthcare Decisions for You
One of the primary concerns of a medical POA is determining whom you want to make your healthcare decisions for you in the event that you are unable to do so. Some of the important questions you should ask yourself include:
- Do you have someone in mind, such as a partner or a trusted family member?
- Are you comfortable talking to this person about your future medical care and the kinds of treatment you do and do not want?
- Does the person you have chosen have the capacity, time, and maturity to make important medical decisions on your behalf in a time of crisis?
- Do you believe your loved ones, family members, and friends will respect and support your choice?
Ultimately, you will want to give this matter careful consideration, and visiting with an experienced estate planning attorney can help you understand the important questions to ask.
Two: The Medical Treatment You Do or Do Not Want
Another important consideration that your advance directive should address is those medical treatments you do or do not want to receive. The primary medical decisions tend to involve the following:
- Antibiotics and/or Antiviral Medications–Antibiotics and antivirals are used to treat wide-ranging infections.
- Cardiopulmonary Resuscitation (CPR) –If your heart stops beating, CPR can help restart it (as can a medical device that delivers an electric shock to stimulate your heart back into action).
- Dialysis –Dialysis is a medical treatment that removes waste from your blood and that manages your body’s fluid levels if your kidneys cease to function.
- Mechanical ventilation–If you are unable to breathe on your own, mechanical ventilation can take over for you.
- Organ and Tissue Donation–Organ and tissue donation address your wishes regarding donating your organs and/or tissues and the procedures involved. You can also address the matter of donating your body for scientific study.
- Palliative Care –Palliative care relates only to providing you with comfort and to managing any pain you experience.
- Tube Feeding–Tube feeding supplies your body with nutrients and fluids when you cannot take them in on your own.
Your advance directive should address your wishes on each of these topics, and the best way to help ensure that you achieve your goals is to be as specific as possible and to write your directive as clearly as possible. Consulting with a knowledgeable estate planning attorney is an excellent place to start.
Three: Do Not Resuscitate Orders
Do not resuscitate (DNR) and do not intubate (DNI) orders are common. If it is your wish that medical professionals (or anyone else) do not attempt to resuscitate you in the event that you stop breathing or that you not be intubated in an effort to save your life, this should be included in your advance directive. You can also establish do not resuscitate and do not intubate orders outside of an advance directive by having your primary care physician include either or both in your medical records.
Four: The Specifics
When you consider the 4 things an advance directive should address, it is important to focus on the specifics therein. All of the following should be included:
- The name and contact information for your attorney-in-fact
- Specific and clear answers to basic questions about your medical preferences in the event that you are unable to provide them yourself when the time comes.
- The names and signatures of two competent adults who witness your advance directive (alternatively, the document can be notarized)
An experienced attorney can help ensure that your advance directive adequately addresses your concerns and is legally binding.