What is a Health Care Directive?

A health care directive (also referred to as a living will or advance healthcare directive) is a legal document that informs your family and healthcare providers who should speak for you if you become incapable of making decisions for yourself. A health care directive helps your loved ones and doctors understand your wishes and follow them. Furthermore, its contents can reduce disputes over who should speak for you if this becomes necessary in the future.

Every individual, especially young adults, should create a health care directive. Unfortunately, people often die in hospital settings in ways that don’t correspond with their preferences or wishes – which often leads to stressful discussions between loved ones as they witness them suffer or die; this can create additional suffering, confusion and guilt among your loved ones; thus creating your health care directive will ensure your wishes are carried out according to plan.

At the core of a health care directive lies your proxy, or person you appoint to make decisions for you. They must be someone whom you trust who understands your values, beliefs and preferences; before selecting someone as your proxy it would be beneficial to have conversations about your wishes with that individual; additionally having regular discussions about what your wishes are with family and friends can ensure all understand what it is that you wish.

Your health care representative should abide by the instructions outlined in your advance healthcare directive unless they conflict with legal, ethical or moral obligations, or with medical opinion. If a doctor suspects there may be difficulty adhering to it, they should notify their proxy and let them make their own decision based on how comfortable they feel with it.

Without an advance health care directive in place, state laws will dictate who makes medical decisions on your behalf – typically your spouse, parents, or adult children; however, rules differ by state. Therefore it’s advisable to create an advance directive so you can rest easy knowing your preferences will be honored.

As well as creating a health care directive, it may also be beneficial to create additional documents such as DNR forms or Physician Order for Life-Sustaining Treatment or POLST orders. These can either be attached directly to your directives or produced separately. They provide your healthcare providers with more specific insight into your wishes for treatment such as tube feeding or organ donation after death. Review your health care directives regularly or whenever significant life changes arise, discussing them with family and friends as you go. Also be sure to give a copy to your primary care doctor, hospital or nursing home where applicable and include in their medical files.

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