Living Wills and Other Advance Directives

Advance directives let people explain what kind of medical treatment they want — or do not want — if illness or accident leaves them unable to communicate or make decisions.

There are two types of advance directives: the living will and durable power of attorney. Both are written, legal documents. You can create one by yourself or with a lawyer. The forms vary from state to state. You can cancel or change anything in the document at any time.

With a living will, you write down all your thoughts about your care and treatment. You can share decisions about feeding tubes, being kept alive on a respirator and being given cardiopulmonary resuscitation.

With a durable power of attorney, you choose another person to make medical decisions if you cannot. A durable power of attorney says: If I am not able to make health-care decisions for myself, then I want a surrogate to make those decisions for me. The surrogate (or agent) is usually, but not always, a family member.

Having both a living will and a durable power of attorney for health care is best. The more specific you are when writing a living will, the easier it will be for the person you chose to act as your surrogate to fulfill your end-of-life wishes.

In 1990, Congress enacted the Patient Self-Determination Act (PSDA). This law ensures that patients are informed of their right to prepare advance health-care directives.

Even if you are in good health, you should discuss end-of-life treatment and care directives with your spouse, family members, doctors, nurses and clergy. This will ease the pressures that occur when decisions must be made, especially if you don't have an advance directive yet.

Although more people are using advanced directives, some people avoid them because of a terrible misconception. They think that if their living will says they don't want life-sustaining treatment that they will not be given medical care. This is not correct. You will be given full medical care.