Medical directives, often called advance directives, are legal documents that outline your preferences for medical treatment. These documents communicate your wishes to doctors and family members if you become unable to speak for yourself due to illness or injury. Planning ahead ensures that you receive the care you want and relieves your loved ones of the burden of making difficult decisions during a crisis.
Understanding the different types of medical directives is the first step in taking control of your future healthcare. Whether you are young and healthy or managing a chronic condition, having these documents in place provides peace of mind for everyone involved. This guide will walk you through the various components of medical directives and how to create them effectively.
The Importance of Medical Directives
Many people assume that medical directives are only for the elderly or those with terminal illnesses. However, unexpected accidents or sudden health crises can happen at any age. Without a clear directive, medical professionals must follow standard life-saving protocols, which may not align with your personal values or quality-of-life preferences.
Having a directive in place serves several critical purposes. It ensures your voice is heard even when you cannot communicate. It also reduces conflict among family members who might disagree on what course of action to take. Most importantly, it provides a clear roadmap for healthcare providers to follow, ensuring you receive care that is consistent with your wishes.
Core Components of an Advance Directive
An advance directive is typically made up of two primary legal documents: a living will and a durable power of attorney for healthcare. While they work together, they serve different functions in your medical planning.
The Living Will
A living will is a written document that specifies which medical treatments you want or do not want in specific situations. This usually applies to end-of-life care or situations where you are permanently unconscious. It covers various interventions, such as:
- Mechanical Ventilation: Whether you want a machine to breathe for you if you cannot breathe on your own.
- Nutrition and Hydration: Your preferences regarding feeding tubes or IV fluids if you can no longer eat or drink.
- Palliative Care: Instructions for managing pain and keeping you comfortable, even if you choose to refuse life-prolonging treatments.
- Organ Donation: Your wishes regarding donating organs or tissues after death.
Durable Power of Attorney for Healthcare
The durable power of attorney for healthcare, also known as a healthcare proxy or agent, is a document where you name a specific person to make medical decisions for you. This person only steps in if a doctor determines that you lack the capacity to make your own decisions.
Your healthcare proxy should be someone you trust implicitly. They should be willing to follow your instructions, even if those instructions conflict with their own personal beliefs. It is important to choose someone who can remain calm under pressure and communicate effectively with medical staff.
Additional Medical Orders to Consider
Beyond the standard advance directive, there are other specific medical orders that you or your doctor might implement based on your current health status. These are often used for individuals with serious or advanced illnesses.
Do Not Resuscitate (DNR) Order
A DNR is a medical order written by a doctor. It instructs healthcare providers not to perform CPR if your heart stops or if you stop breathing. This is separate from a living will and is often kept in your medical chart or posted in your home if you are receiving hospice care.
Do Not Intubate (DNI) Order
A DNI order specifically states that you do not want to be put on a breathing machine (ventilator) if you experience respiratory failure. You can have a DNI even if you choose to allow other forms of resuscitation, such as chest compressions or medication.
POLST and MOLST Forms
POLST (Physician Orders for Life-Sustaining Treatment) or MOLST (Medical Orders for Life-Sustaining Treatment) are forms intended for people with serious illnesses. Unlike a living will, which is a general statement of intent, these are actual medical orders signed by a physician. They translate your wishes into actionable instructions that emergency responders and hospital staff must follow immediately.
How to Create Your Medical Directives
Creating medical directives does not have to be a complicated legal process. You can often complete the paperwork yourself without hiring a lawyer, though you may want to consult one for complex situations. Follow these steps to get started:
- Research Your State Laws: Requirements for medical directives vary by state. Ensure you use the correct forms for your place of residence. Many state health departments and hospital websites provide these forms for free.
- Reflect on Your Values: Think about what “quality of life” means to you. Consider your religious beliefs, personal philosophy, and what treatments you would find acceptable or unacceptable in various health scenarios.
- Choose Your Proxy: Talk to the person you want to name as your healthcare agent. Confirm they are willing to take on the responsibility and understand your medical preferences.
- Fill Out the Forms: Be as specific as possible in your living will. Use clear language to describe your wishes regarding life support and comfort care.
- Get the Documents Witnessed: Most states require your signature to be witnessed by two adults or notarized by a notary public to make the document legally binding.
Storing and Sharing Your Directives
A medical directive is only useful if people can find it when it is needed. Do not simply put the document in a safe deposit box or a locked drawer where no one can access it during an emergency. You should be proactive about sharing copies with the right people.
Give a copy to your primary care physician to be included in your electronic medical record. Provide a copy to your designated healthcare proxy and any close family members. You might also consider keeping a small card in your wallet stating that you have an advance directive and where it is located.
Many hospitals now allow you to upload your directives directly to their patient portals. This ensures that if you are admitted to that hospital system, your doctors will have immediate access to your instructions.
When to Review and Update Your Directives
Medical directives are not set in stone. You can change or revoke them at any time as long as you are mentally capable. It is a good practice to review your documents periodically to ensure they still reflect your wishes.
Experts recommend reviewing your directives during major life transitions, often referred to as the “Five Ds”:
- Decade: Review your documents every ten years.
- Death: Review if a close friend or family member passes away.
- Divorce: Update your documents if your proxy was a former spouse.
- Diagnosis: Review if you receive a diagnosis of a serious or chronic health condition.
- Decline: Reassess your wishes if your health significantly declines or you lose independence.
If you make changes, ensure you destroy old versions and distribute the updated copies to your doctor and proxy immediately. Clear communication is the key to ensuring your directives are followed accurately.
Common Misconceptions About Medical Directives
One common myth is that a medical directive allows doctors to “give up” on you. In reality, these documents only apply when you are unable to make decisions and are in a specific medical state defined by the document. Doctors are legally and ethically obligated to provide all necessary care until the conditions of your directive are met.
Another misconception is that you need a lawyer to create an advance directive. While legal advice can be helpful, most people can use standard state-approved forms. These forms are designed to be straightforward and accessible to the general public.
Finally, some believe that naming a healthcare proxy means losing control over your care. Your proxy only has authority if you cannot speak for yourself. As long as you are conscious and able to communicate, you remain the primary decision-maker for all your medical treatments.
Conclusion
Creating medical directives is a vital part of adult life. It ensures that your medical care remains in your hands, even during times when you cannot voice your preferences. By taking the time to document your wishes and choose a trusted proxy, you protect yourself and provide your family with the clarity they need during difficult times.
If you haven’t started your advance care planning yet, consider downloading your state’s forms today. For more information on navigating healthcare and legal planning, explore our other helpful articles on SearchAndHelp.com, such as our guides on estate planning basics and choosing the right health insurance.