Healthcare Directives FAQ

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What if I really don't know anyone I trust to supervise my medical care?

Naming a healthcare proxy is an optional part of completing your healthcare directive. It is better not to name anyone than to name someone who is not comfortable with the directions you leave--or who is not likely to assert your wishes strongly.

Medical personnel are still technically bound to follow your written wishes for your healthcare--or to find someone who will care for you in the way you have directed. It is far better to put your wishes for final healthcare in writing than to let the lack of a representative stand in the way.

What types of medical care should I consider when completing my healthcare documents?

Technological advances mean that currently unfathomable procedures and treatments will become available and treatments that are now common will become obsolete. Also, the treatments that are available vary drastically with region, depending on the sophistication and funding levels of local medical facilities.

While putting together your healthcare directive, the best that you can do is to become familiar with the kinds of medical procedures that are most commonly administered to patients who are terminally ill or permanently comatose. Those most commonly administered include:

• blood and blood products
• cardio-pulmonary resuscitation (CPR)
• diagnostic tests
• dialysis
• drugs
• respirators, and
• surgery.

Can I leave instructions about pain medication, or about food and water?

The laws of most states assume that people want relief from pain and discomfort and specifically exclude pain-relieving procedures from definitions of life-prolonging treatments that may be withheld. Some states also exclude food and water (commonly called nutrition and hydration) from their definitions of life-prolonging treatments. But there is some controversy about whether providing food and water, or drugs to make a person comfortable, will also have the effect of prolonging life. Some people are so adamant about not having their lives prolonged when they are comatose or likely to die soon that they choose to direct that all food, water and pain relief be withheld, even if the doctor thinks those procedures are necessary. Under the U.S. Constitution, you are allowed to leave these instructions even if your state's law is restrictive; your doctors are legally bound to follow your wishes.

On the other hand, some people feel concerned about how much pain or discomfort might be felt when close to death from a terminal illness or in a permanent coma; these people are willing to have their lives prolonged rather than face the possibility that discomfort or pain would go untreated. Obviously, it's a very personal choice; you're free to leave the instructions that feel right for you.

How can I be sure my documents are legal?

There are a few requirements you must meet to make a valid healthcare directive. In most states, you must be 18 years old, though a few states allow parents to make healthcare directives for their minor children. All states require that the person making a healthcare directive be able to understand what the document means, what it contains and how it works.

Also, every state requires that you sign your documents. If you are physically unable to sign them yourself, you can direct another person to sign them for you.

You must sign your documents, or have them signed for you, in the presence of witnesses or a notary public--sometimes both, depending on your state's law. The purpose of this additional formality is so that there is at least one other person who can confirm that you were of sound mind and of legal age when you made the documents.

Where can I get a healthcare directive--and who can help complete it?

Many people first realize the need for healthcare documents when they're being admitted to a hospital. But hospital admission time is probably not the best time to learn about your options in directing healthcare or to reflect on your wishes. It's better to get information and complete your documents when you're under less stress.

Local senior centers may be good resources for help. Many of them have trained healthcare staff on hand who will be willing to discuss your healthcare options. The patient representative at a local hospital may also be a good person to contact for help. And if you have a regular physician, you can discuss your concerns with him or her.

Local special interest groups and clinics may provide help in obtaining and filling out healthcare directives--particularly organizations set up to meet the needs of the severely ill such as AIDS groups or cancer organizations. Check your telephone book for a local listing--or call one of the group's hotlines for more information or a possible referral.

There are also a number of seminars offered to help people with their healthcare documents. Beware of groups that offer such seminars for a hefty fee, however. Hospitals and senior centers often provide them free of charge.

Copyright 1999 Nolo.com, Inc.

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