What are Advance Directives?
Advance Directives are written, legal documents that allow you to make your healthcare wishes known in case you are unable to communicate. They guide your family and healthcare team through the medical treatments you wish to receive. It does not mean “don’t treat,” but does mean “treat me the way I want to be treated.” Studies show that even close family members often do not know each other’s wishes for end of life choices. Caring spouses often guess incorrectly about what kind of treatment their husband or wife would want.
Advance Directives are important because they:
In Pennsylvania, Living Wills and Durable Power of Attorneys for Healthcare DO NOT require a lawyer and do not require notarization. Pennsylvania law gives you the right to accept or refuse medical care.
It’s important to understand the difference between these free legal documents that relate to health care concerns, versus the legal documents that relate to financial concerns. This document clarifies the difference between these forms, including the purpose and the process.
Facts about Living Wills:
A Living Will is specific to end-stage medical conditions and describes the kind of treatment you want or do not want if you cannot tell your doctor yourself. Living Wills only apply to patients who have an end-stage medical condition OR are permanently unconscious AND who are incompetent. In other words, it applies only when medical treatment would prolong the dying process or keep you unconscious with no hope of waking. Your Living Will must be signed by you and witnessed by two other adults.
Your treating doctor can only follow your Living Will if:
Facts about Durable Power of Attorney (DPOA):
In a Durable Power of Attorney for Healthcare, you name another person to make treatment decisions for you anytime you lose the ability to communicate your wishes. This person is a guide for your treatment decisions. The DPOA is a more flexible document that can be used anytime you have treatment needs.
It is important to name someone who knows your wishes and who you trust to follow them. It is a good idea to choose a second or alternate DPOA. The Durable Power of Attorney for Healthcare Form must be signed by you and witnessed by two other adults who are not your named decision makers. It is recommended that Financial Wills and Financial Power of Attorneys be drafted by an attorney. Other names for DPOA include Medical Power of Attorney, Healthcare Agent, Healthcare Proxy, and Surrogate.
Does my doctor have to follow my Advance Directive?
Most healthcare facilities have policies to follow your Advance Directive, as long as it is valid under Pennsylvania law. If your doctor feels that the decisions being made are not in your best interest, he will talk to your decision maker and try to come up with a plan that works for everyone.
Can I change my mind?
You may change or cancel your Advance Directive at any time simply by telling your doctor or other healthcare provider. It is important to tell every healthcare provider and others who have a copy of your Advance Directive, including your hospital. You should include dates of the signatures.
Do I have to write an Advance Directive?
No, it is your decision whether to write one or not. Your treatment and its cost DO NOT depend on whether you have an Advance Directive.
If you do not have an Advance Directive and you cannot make treatment decisions for yourself, your doctor may discuss what treatment you should receive with your family members in the following order:
All Adults Need Advance Directives
Most people realize advance care planning is important as we age. However, advance care planning is important for younger people too. If you were ill or injured and unable to speak, who would know what kind of care you would want? Regardless of your age or health condition, it is important to discuss your choices before a health crisis.
The leading cause of death for those under the age of 40 is accidental trauma (such as motor vehicle accidents and drowning). These accidents can result in a state where the brain does not work and the person can’t make decisions. The well-known, publicized cases of Karen Ann Quinlin and Terri Schiavo are examples. They were in their twenties when their life-altering events occurred.
Accidents cannot be predicted in advance. Everyone needs to talk about advance care planning, not just older people. All adults over the age of 18 should discuss their choices with loved ones and complete Advance Directives.