News

The responsible choice: Why we need advance directives

When it comes to end-of-life health decisions, are you like most other Americans? Would you say, as about 60 percent of adults do, that you’d want your wishes regarding medical care and interventions to be respected? If your answer is “Yes”, another question must follow: Do you have an advance directive, living will, or durable power of attorney for health care?

Simply put, an advance directive is a written declaration of your wishes regarding medical treatment. Its purpose is to ensure that doctors, family and friends will respect your health care preferences in situations where you are not able to communicate them. These statements can address any number of issues and take on various forms including a living will and a medical power of attorney.

With a living will you can express your wishes regarding medical treatment and especially life-sustaining care. More specifically, some questions you would answer are: Would you want health care providers to use dialysis machines, ventilators, respirators and other life-sustaining equipment? If you cannot be fed by mouth, would you want to be tube fed? Would you want CPR if your breathing or heartbeat stops? (If not you can include a “Do not resuscitate” order, also known as DNR, in the document.) A medical power of attorney (POA) allows you to name another person as your health care agent or health care proxy. The assigned family member or friend will make health care decisions for you if you are no longer able to. This could happen because of age related dementia or because you have fallen into a coma after an accident. The document takes effect when a doctor declares you incapable of making your own decisions.

According to a study conducted last year in Maryland, only about one in three adults in the United States have completed an advance directive. Why so few? About one in four of the people surveyed did not know that such a thing existed. And the rest? Human nature, I would say. We’d all rather not think about the consequences of a serious accident or about what will happen to us when our life nears its end. But setting up an advance directive is the responsible thing to do. After all, if we reach a stage where we cannot make medical decisions anymore, somebody will have to speak for us. Do we really want to leave that person — a doctor, somebody we love — guessing what our wishes are?

by Kevin J. Moore