An advance directive is a legal document that ensures an individual’s preferences for medical treatment and health care decisions are respected if they become incapacitated or unable to communicate their wishes. This document often comprises a Health Care Power of Attorney and a Living Will, allowing individuals to appoint a health care proxy and specify the types of medical intervention they desire or wish to avoid.
Components of Advance Directive
Health Care Power of Attorney
A Health Care Power of Attorney (HCPOA) designates a trusted person, known as a health care proxy or agent, to make medical decisions on behalf of the individual. This component becomes essential when the person is unable to make or communicate these decisions personally.
Living Will
A Living Will is a legal document that outlines specific medical treatments and interventions the individual wishes or does not wish to receive in case of serious illness or incapacity. The living will provide explicit instructions to health care providers and loved ones, ensuring that the person’s desires regarding life-support and other critical treatments are honored.
Types and Variations
Do Not Resuscitate (DNR) Orders
A Do Not Resuscitate (DNR) order is a special medical directive often integrated into an advance directive, stating that the individual does not wish to undergo CPR or advanced cardiac life support (ACLS) if they stop breathing or their heart stops.
POLST/MOLST
Physician Orders for Life-Sustaining Treatment (POLST) or Medical Orders for Life-Sustaining Treatment (MOLST) are medical orders specifying the types of life-sustaining treatment an individual desires. These documents complement, but do not replace, the advance directive, and are often used for individuals with serious health conditions.
Special Considerations
Legal Requirements
The specific legal requirements for an advance directive vary by jurisdiction. It is crucial to consult with legal professionals to ensure the document meets all local requirements and is legally enforceable.
Regular Updates
Individuals should periodically review and update their advance directive to reflect any changes in their health status, personal wishes, or legal considerations.
Applicability and Examples
Advance directives are essential for adults of all ages, providing guidance and security in unforeseen medical situations. For example, an elderly person may specify in their living will that they do not wish to receive mechanical ventilation or tube feeding. A younger person might appoint a trusted friend as their health care proxy in case of a severe accident.
Historical Context
Advance directives emerged in the latter half of the 20th century as a response to advances in medical technology and the increasing complexity of end-of-life care. The first living wills were introduced in the 1960s, and the concept has evolved significantly over the decades, particularly following high-profile legal cases and legislative changes.
Comparisons and Related Terms
Health Care Proxy
A Health Care Proxy is designated through the Health Care Power of Attorney and is responsible for making healthcare decisions on behalf of the individual.
Durable Power of Attorney
A Durable Power of Attorney is broader than a Health Care Power of Attorney, as it can encompass financial and legal decision-making in addition to health care decisions.
FAQs
Is an advance directive the same as a living will?
How often should I update my advance directive?
Do I need a lawyer to create an advance directive?
References
- U.S. Department of Health and Human Services. “Advance Directives.” National Institute on Aging, 2021.
- American Bar Association. “Making Medical Decisions for Someone Else: A How-To Guide.”
- National Hospice and Palliative Care Organization. “Understanding Advance Directives.”
Summary
An advance directive is a critical legal document that helps individuals convey their medical preferences and appoint a health care proxy for situations where they cannot make decisions themselves. By integrating a Health Care Power of Attorney and a Living Will, it ensures that one’s health care choices are respected and followed, providing peace of mind and guidance to loved ones and healthcare providers.
