Many of us find it difficult to think about the end of life. We all know that our death is inevitable but we often avoid planning for it. Whether you are confronting a serious illness or preparing for the future, planning for the end of life can be empowering and can provide comfort to everyone involved.

Mentally competent adults have the right to control their own medical treatment and make decisions about their medical care. However, if an adult is unable to communicate with doctors and other health care professionals about their medical treatment advance directives can play a critical role.

Advance directives help you prepare for the end of life and make decisions consistent with your principles and values. The two most common advance directives are a living will also known as a medical directive and a health care proxy. Creating these documents ensure that your rights are protected and you are in control of your health care decisions.

Health Care Proxy and Living Will/Medical Directive

A health care proxy is a legal document that appoints another individual, known as a health care agent, to make medical decisions on your behalf if you are unable to make those decisions yourself. The health care agent can make end of life medical decisions or medical decisions at any time that you may be unable to communicate your wishes directly.

A medical directive or living will is a legal document that specifies the type of life sustaining treatments or procedures you would withhold or withdraw under certain circumstances. Sometimes people complete a combined health care proxy and medical directive document so their health care agent has all the information in one document. The health care proxy and medical directive are only in effect if you are unable to communicate your wishes regarding medical treatment. Both documents allow you to exercise control over your medical and health care decision-making and ensure that your wishes are followed.

Getting Started

Choosing the right person as your health care agent and alternate agent is an important first step. You should consider this choice carefully. It is crucial that your agent and alternate agent are comfortable in this role. Your agents may have to make difficult decisions about end of life care and treatment and should be willing and able to act on your behalf. It is important that you discuss your health care proxy and living will or medical directive with the agents before you appoint them.

There are many living will and medical directive forms. Some are very detailed and some take a broader approach. Consider the life prolonging treatments or procedures you would withdraw or withhold and the circumstances under which you would withdraw or withhold such procedures. For example, if your treating physician determines that you are permanently unconscious, you may want to indicate that under that circumstance you do not want any form of life support. The best strategy is to talk to your doctor and other health care professionals about your options so you can make the most informed decisions.

Discuss your advance directives with your family and friends so that they understand your wishes and will be supportive of your health care agent as well as the instructions provided in your living will and medical directive. Clearly stating your intentions about the type of medical treatment and care you want and appointing someone to make medical decisions if you are unable to do so provides guidance and instructions to the people in your life. This may ease some of the burden your loved ones endure during end of life situations and can reduce or even eliminate disagreements between friends and family members. With appropriate planning and by implementing the right legal documents, you can provide instructions, guidance and support to your loved ones as they work with your health care providers.