What Are Advance Directives?

The term advance directive describes two types of legal documents that enable you to plan for and communicate your end-of-life wishes in the event that you are unable to communicate:

• A living will allows you to document your wishes concerning medical treatments at the end of life.
• A medical power of attorney (or health care proxy) allows you to appoint a person you trust as your health care agent (or surrogate decision maker), who is authorized to make medical decisions on your behalf.

Advance directives are legally valid throughout the United States.  While you do not need a lawyer to fill out an advance directive, your advance directive becomes legally valid as soon as you sign them in front of the required witnesses.  The laws governing advance directives vary from state to state, so it is important to complete and sign advance directives that comply with your state's law.  Also, advance directives can have different titles in different states.  Before your Living will can guide medical decision-making two physicians must certify:

• You are unable to make medical decisions,
• You are in the medical condition specified in the state's living will law (such as "terminal illness" or "permanent unconsciousness"),
• Other requirements also may apply, depending upon the state.

Before most states Medical power of attorney goes into effect a persons physician must conclude that they are unable to make their own medical decisions.   In addition:

• If a person regains the ability to make decisions, the agent cannot continue to act on the persons behalf.
• Many states have additional requirements that apply only to decisions about life-sustaining medical treatments.
• For example, before your agent can refuse a life-sustaining treatment on your behalf, a second physician may have to confirm your doctor's assessment that you are incapable of making treatment decisions.

What Else Do I Need to Know?

• Emergency medical technicians cannot honor living wills or medical powers of attorney.  Once emergency personnel have been called, they must do what is necessary to stabilize a patient for transfer to a hospital, both from accident sites and from a home or other facility.  After a physician fully evaluates the person's condition and determines the underlying conditions, advance directives can be implemented.
• One state’s advance directive does not always work in another state.  Some states do honor advance directives from another state; others will honor out-of-state advance directives as long as they are similar to the state's own law; and some states do not have an answer to this question.  The best solution is if you spend a significant amount of time in more than one state, you should complete the advance directives for all the states you spend a significant amount of time in.  It will be easier to have your advance directives honored if they are the ones with which the medical facility is familiar.
• Advance directives do not expire.  An advance directive remains in effect until you change it. If you complete a new advance directive, it invalidates the previous one.
• You should review your advance directives periodically to ensure that they still reflect your wishes. If you want to change anything in an advance directive once you have completed it, you should complete a whole new document.

  
  
  Sample Advanced Directive Form

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