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A Guide to Living Wills and Health
Care Proxies
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Advance Care Directives
It’s never easy to ponder death, whether you’re facing the demise of a loved one or the end of your own life. But taking some time to think and plan ahead for those final hours or days can be a future blessing for your family and others close to you. Living wills and health care proxies—documents known as advance care directives—give you a voice in decisions about your medical care. Less than 30% of Americans have filled out advance directives. Yet without these documents, choices may be left up to a doctor or someone appointed by a judge—a person who may not know your values, beliefs, or preferences (your health care philosophy).
You can hope your health will be sound for the rest of your life, but there are no guarantees. So take the time to learn about and complete the necessary forms—and the sooner the better. Even if you’re in perfect health, you never know when life may throw a medical crisis your way. That’s why everyone over age 18 should have a living will or health care proxy. As you get older, this becomes more crucial; half of hospital stays and 80% of deaths involve people over age 65.
A Guide to Living Wills and Health Care Proxies is a report from Harvard Medical School designed to help you protect your rights. Although health care proxies and living wills are important forms to fill out, they're not difficult to understand, and you don't need a lawyer's help. This report explains the process, gives you tips on how to talk about this difficult subject, and provides you with the actual forms and worksheets you need. (updated: 2007)
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Table of Contents:
- Advance
care directives
- Health care proxy
- Choosing an
agent
- Living will
- Which document?
- Creating your health
care proxy or living will
- Your health care
proxy
- Your living will
- Other things
you need to do
- Clearing up confusing
terms
- Considering medical procedures
- A crucial step: Talking
about your wishes
- Talking to your
health care agent
- Talking to your
doctor
- Broaching the
subject
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- When and how to change
your directives
- Privacy rules and health care proxies
- Forms
- Health Care Proxy
- Living Will Worksheet
- Generic Living
Will
- Advance Care
Directives Tracking Sheet
- State-specific information
- Resources
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Here’s an excerpt from A Guide to Living Wills and Health Care Proxies Special Health Report
Most people want a say in all life’s important decisions. The same should be true regarding decisions surrounding death, such as what kind of medical treatment you receive. But what if you’re unable to make your decisions or wishes known? Say, for example, you are unconscious and can’t speak or hear. Unless you have spoken with your loved ones and taken certain legal actions, there may be confusion and stress over what those decisions will be and who can make them for you.
Living wills and health care proxies—documents known as advance care directives—give you a voice in decisions about your medical care. Less than 30% of Americans have filled out advance directives. Yet without these documents, choices may be left up to a doctor or someone appointed by a judge—a person who may not know your values, beliefs, or preferences (your health care philosophy). Or, a family member who doesn’t know about your wishes may make decisions for you. For example, suppose a woman is unable to communicate because of a brain tumor and her only living relative is a brother with whom she hasn’t spoken in 10 years. She and her best friend have talked frankly about her desire not to be put on life support or fed intravenously. Legally, her brother may get to make such decisions, although clearly he’s not the person most familiar with her desires. But if that woman had taken the simple steps to legally name her friend as her health care agent, she would have lived her last days as she wanted.
Advance care directives enable you to choose someone to make health care decisions for you if you are unable to do so, let you specify what kinds of treatment or goals of treatment you’d like in different circumstances, and allow a consistent plan to emerge over all by providing a base upon which to build your health care philosophy. Some people worry that by filling out these documents, they’re giving up control over their medical treatment. But in reality, advance care directives help you assert control over your health care. As long as you are able to make and communicate your decisions, your word supersedes anything you’ve written or said to others. It’s only when you’re unconscious or too ill to make your wishes known that any type of advance care directive goes into effect. If your medical condition improves and you can once again make and express your decisions, your oral statements once again take precedence.
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