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advanced care directives

Alternative Names
Living Will, Health Care Power of Attorney, Advance Health Care Directive

Definition

Advanced Care Directives are documents in which a person gives instructions to family and healthcare professionals. They provide directions regarding future medical care. They are used when an individual becomes unable to make decisions. They can also be used when the person cannot, for whatever reason, communicate decisions personally.

Since none of us can predict the future, it is important for one to think ahead of time about his or her desires in case one's health should suddenly worsen. One should discuss these issues with his or her family, then check into the laws governing advance directives in his or her state of residence and have proper documents written to ensure that his or her desires are carried out.

Information

In the U.S., the Patient Self- Determination Act gives people the right to accept or refuse treatment. Advanced care directives are documents that communicate these decisions.

The type of documents vary from state to state, but they may include the following:

A Living Will allows people to define what treatment they want to receive in certain situations. They can also refuse any treatment. For example, people can give instructions about what to do if they have a terminal illness. The Living Will can also define what to do if someone becomes permanently unconscious. Individuals can spell out what treatments they want withheld or stopped if they are dying without hope of recovery.

These treatments may include the following:

A Health Care Power of Attorney, or HCPA, allows a person to choose someone to make his or her healthcare decisions if the person is incapacitated. It can cover any healthcare decision. The person does not need to be dying or unconscious for it to take effect.

An Advance Health Care Directive has some of the features of the Living Will. It also has features of the HCPA. Some states have special forms or requirements for this type of document. Laws and documents for Advanced Care Directives vary from state to state.

It is important to consult with a knowledgeable person when setting up a directive. It's also helpful to tell family members and healthcare professionals about the document and where to find it. A copy of the document may be given to professionals and selected family members.


Author:James Broomfield, MD
Date Written:12/13/99
Medical Review:Larry Gee, MD
Date Written:1/16/2007
Reviewer:Reginald Finger, MD
Date Reviewed:1/30/2007
Contributors
Potential conflict of interest information for reviewers available on request