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Establishing and Personalizing Your Advance Health Care Directive

A well-designed estate plan will include an advance health care directive, which is comprised of a living will and a health care proxy. A living will lays out your wishes for your medical care should you become incapacitated and it covers whether to artificially prolong your life, among other things. A health care proxy allows you to name someone with legal authority to make health-related decisions for you if you are unable to make them yourself. I cannot over-stress the importance of establishing an advance health care directive – regardless of your age – and updating it regularly. Without it, should you become unable to speak for yourself, there is no guarantee that your loved ones will know what direction to give, or that your health care providers will follow your loved one’s direction. Take, for example, the infamous case of Terri Schiavo — the 26 year-old woman who sustained a cardiac arrest, was successfully resuscitated, but was left comatose due to lack of oxygen to her brain. Ms. Schiavo who remained in a persistent vegetative state for years while her family fought over what to do — is a sad example of the worst-case scenario of what can happen when someone becomes incapacitated without an advance health care directive.

An advance health care directive can be especially helpful to your doctors and loved ones when you supplement it with specific information about your health-care preferences. To personalize your directive, I recommend the following considerations to guide you in documenting your wishes about life-sustaining medical care. (Feel free to add other topics that are important to you – this is your life and your wishes.)

  1. Types of illnesses to which your advance directive would apply.

  2. What is important to you? What makes your life worth living?

  3. What conditions would you find horrible to live with long-term? What would be a fate worse than death?

  4. What would be an acceptable level of “better?” For example, you would not like it but you would be willing to live with X.

  5. What would be important to you as you die (e.g., free from pain)? What is a good death, in your opinion?

  6. What is your preference regarding cardiopulmonary resuscitation (CPR), and being on a ventilator (breathing machine) and/or feeding tubes?

  • Would you be willing to be on a ventilator and/or have a feeding tube for a short period of time to recover from illness/injury? What is a short period of time, in your opinion?

  • Would you be willing to be on a ventilator and/or have a feeding tube for the rest of your life? How long would you want to live on a ventilator and/or feeding tube?

  1. What reassurances do you want to provide for your decision maker(s)? Imagine the person who will be making the decisions for you is sitting beside your hospital bed. What would you want to say to help that person feel more comfortable and confident that he/she is making the right medical decisions for you?

  2. What do you want the doctors to know about honoring your religious/cultural beliefs both while you are sick and/or while you are dying?

  3. Is there anything else that you want your doctor to know about you that would help him/her care for you?

You have the right to make our own health care decisions, but what if there comes a time when you cannot speak for yourself? An advance directive ensures that your end-of-life and other critical healthcare decisions will be followed. Importantly, it relieves the burden on your loved ones of having to make difficult health care decisions for you without knowing your wishes. An advance health care directive makes your health care wishes known to your doctors and loved ones, provides critical guidance to them for making decisions, and protects your rights to accept or refuse medical care. Supplementing your directive with personalized responses to the above-provided considerations can further help your family, friends, and doctors make critical medical decisions on your behalf. This article provides only general legal information and does not provide specific legal advice. Information contained herein is not a substitute for a personal consultation with an attorney. Pratt Law offers a complementary consultation to discuss whether we can help you with your estate planning, administration, or probate needs.

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