What Is an Advance Health Care Directive (or Living Will)?
What is an advance health care directive (or living will)?
Helping someone prepare for end-of-life medical decisions can be of great comfort to both the person and to others in his family. The document that helps you do this is an advance health care directive, or living will -- what it's called and what it includes depends on where the person lives -- sometimes paired with a power of attorney for health care. For information about how to set up an advance health care directive or living will, see Advance Health Care Directives and Living Wills: A Step-by-Step Guide.
Such a document is important because, given a medical situation in which someone can't speak for himself -- anything incapacitating, from a short, temporary condition to a long terminal illness -- it lets medical providers and other decision makers know his preferences, and it can authorize someone to speak on the person's behalf. Without an advance health care directive or living will, patients who can't communicate may be left to the confused decisions of squabbling family members or the mercy of doctors who might use artificial means to prolong life, or refuse to do so, regardless of what the patient would want.
An advance health care directive is the primary legal tool for protecting a person's healthcare wishes if and when he can't speak for himself. The health care directive applies any time the person is unable to communicate, whether or not the situation is life threatening, and for however long is necessary. Examples are a patient's temporary condition after an incapacitating stroke or his chronic state during the long-term, late stages of Alzheimer's disease.
An advance health care directive can set out the person's wishes regarding the specific care he does and doesn't want, and it can appoint someone -- usually a close family member -- to supervise that care or to make decisions for him when he's unable to do so. An advance health care directive would not override the person's direct control over his care as long as he can still speak for himself.
What is an advance health care directive supposed to accomplish?
Advance health care directives come in several varieties and go by several names, depending on the state where a person lives. Advance health care directive is the general name for all these documents. Some of the other names for particular documents are advance directive, living will, health care declaration, medical power of attorney, durable power of attorney for health care, and patient advocate designation.
These documents -- either one document alone, or two in combination -- are meant to protect a person in two ways if and when he can't communicate:
- The person can set out the specific types of healthcare -- usually including artificial life-prolonging care, artificially administered food and water, and comfort care -- that he does and doesn't want. In most states, this care can be specified if the person is either close to death from a terminal condition or considered permanently comatose. This clarifies things not only for family but also for medical providers, who are bound by law to follow the patient's wishes or find another provider who will agree to follow them.
- The person can name someone to act on his behalf in making healthcare decisions when he can't do so himself. This designated agent, who's given legal power to act by the document, can make sure that the patient's wishes are carried out and can make any other healthcare decision that wasn't specified in the document.