Healthcare Today Legal and Political Issues

Giving Yourself a Voice: Advanced Directives

Terri Schiavo's family probably never imagined the decisions they would have to make regarding her care. But the court battle surrounding this 41-year-old woman, who was in a vegetative state since a 1990 heart attack, has reminded us all about the importance of clearly informing your family of your wishes regarding end-of-life medical care.

The U.S. government has granted citizens the right to have certain documents, called advanced directives, which allow mentally competent people to outline their health-care decisions for a time in the future when they are unable to speak on their own behalf. These provisions give you control over the type and degree of treatment you desire should your life be in jeopardy.

Advanced directives are a difficult subject to even think about, let alone broach with family, but it is an important conversation to have in order to ensure that you live—and die—according to your own desires.

All about Advanced Directives
An advanced directive is any legal document that allows a patient to express his or her wishes concerning health care. There are three major forms of advanced directives: a living will, durable power of attorney (DPA) for health care and a do not resuscitate order (DNR). Be advised that different states have different laws regarding advanced directives, so be sure to find out about the laws in your particular area.

In general, anyone 18 or older can obtain an advanced directive. Again, different states have different laws pertaining to the number and types of witnesses needed for such a document. But in all cases, it is important to discuss your end-of-life health care desires with your family, so that they clearly understand your wishes if a major medical decision has to be made.

Living Wills
A living will is an advanced directive that is only used should you become terminally ill. Two doctors must agree that a patient is either in an irreversible coma or has less than six months to live and is unable to make medical decisions.

In a living will, a person can describe the types of treatment that should be administered or withheld in certain situations. This document is legally binding and cannot be overturned by anyone, including doctors or family members, other than the patient. The patients themselves can revoke this document at any time by telling a witness, tearing it up or putting their new decision in writing.

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