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Medical Author:

Siamak T. Nabili, MD, MPH

Siamak T. Nabili, MD, MPH

Dr. Nabili received his undergraduate degree from the University of California, San Diego (UCSD), majoring in chemistry and biochemistry. He then completed his graduate degree at the University of California, Los Angeles (UCLA). His graduate training included a specialized fellowship in public health where his research focused on environmental health and health-care delivery and management.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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In this Article

• Advance medical directive facts
• Introduction to advance medical directives
• What is the importance of an advance directive?
• What is the history of advance directives?
• The current situations
• When do advance directives become helpful?
• How can one obtain and prepare living will and advance medical directive forms?
• Advance Medical Directives Index

Preparing documents for a living will and advance directive can be done at any time during an adult person's lifetime. As one's preference can naturally change during one's life, these documents can also be amended and modified to reflect the changes.

Obtaining medical advance directive documents is simple. Medical offices, hospitals, social workers, attorneys, and even post offices may carry these documents. In fact, hospitals receiving medical and Medicaid payments are required to offer their patients these documents.

A good place to begin this process is an open discussion with a primary-care doctor or other treating physicians. As stated earlier, living wills and advance directives can be very broad or quite specific. Meanings, implications, risks, and benefits of components of an advance directive deserve clear understanding before they are signed in a legally binding document that may be relied upon for end-of-life decisions.

Selecting a person as a medical power of attorney is also an important decision. The surrogate decision maker does not necessarily need to be a family member or a relative. In truth, any person in whom an individual trusts to carry out their wishes on their behalf and in good faith, can be designated as a health-care proxy.

Additionally, because these are legal documents of various forms, appropriate and accurate drafting with the help of an attorney is advised. Furthermore, as regulations may vary from state to state, your attorney can also guide you through how to do a living will and an advance directive.

Although it is highly encouraged, it is often difficult to address issues pertaining to terminal illnesses, end-of-life care, and death with loved ones and caregivers. Despite having proper documentation, it is important for family members and caregivers to have some general knowledge about a patient's preferences. More importantly, family members or anyone close to the individual must know where these documents are located and be able to provide them or refer to them in cases of emergency. It is also extremely beneficial to have extra copies of these documents and to bring them with the patient to the hospital, emergency room, or even doctors' offices.

Previous contributing author: Maude Bancroft Hecht, RN

REFERENCE:

Farkas, Henry. "End-of-Life Decision Making." eMedicineHealth.com. Aug. 10, 2005. <http://www.emedicinehealth.com/end-of-life_decision_making/article_em.htm>.