Health Care Directives - Frequently Asked Questions

Health Care Directives – FAQs

Common Questions

The following FAQs may address several questions you have regarding health care directives.

What is a health care directive?

A health care directive, also called an advance directive, is a legal document that describes your healthcare wishes for any circumstance when you are unable to express your own medical treatment preferences. A health care directive usually includes two parts: healthcare instructions that describe your treatment preferences and a durable healthcare power of attorney that names your healthcare agent.

When is a health care directive used?

Your health care directive is only used when you are unable to make or communicate your own healthcare decisions.  It typically applies to end-of-life healthcare decisions, but can also be helpful if you become temporarily incapacitated due to a sudden injury or illness.

How is a health care directive different from a living will?

While a living will records your wishes for your end-of-life health care, a health care directive is broader because it typically includes healthcare instructions and a healthcare power of attorney.

How are healthcare instructions different from a living will?

Though many people use the terms living will and healthcare instructions interchangeably, they are different. A living will typically describes treatment you do not want to receive at the end of your life. The emphasis is place on withholding or withdrawing treatment. Many states instead use healthcare instructions because they typically include both the medical treatments you want to receive as well as the treatments you do not want to receive.

What if I already have a living will? Why do I need a health care directive?

As noted above, a health care directive has two parts: healthcare instructions and a healthcare power of attorney.  So, first ask yourself whether your current living will has enough information to be really useful to those who might have to make medical decisions on your behalf. Does it include the healthcare treatments you do want to receive, as well as those you might prefer to have withheld in certain situations? Does it reflect your values and wishes? If not, take time to write meaningful healthcare instructions. Secondly, have you named a healthcare agent? If not, be sure to complete a healthcare power of attorney to name a healthcare agent and an alternate.

What is a healthcare power of attorney?

A healthcare power of attorney is the legal document that names the person who will make healthcare decisions on your behalf if you are unable to make or communicate your own decisions. It is one part of a health care directive. The person you select may be called a healthcare agent, healthcare surrogate, healthcare representative or healthcare proxy. States use different terms, but they all refer to the person who is legally empowered to make medical decisions on your behalf if you are unable to do so.

How does my health care directive become legal?

In order for your document to be legal, it must be executed. You must sign the document in front of witnesses. Requirements for witnesses differ by state. MyCare Directive provides instructions for your state as part of your health care directive document. To make your document most useful in other states (in case it is needed and you are traveling), have the document signed by two witnesses and a notary public.

What should I do with my health care directive?

After you have executed the document, you need to make it accessible to your healthcare agent and alternate(s), your healthcare provider(s), and loved ones whom you choose. You might also include your attorney and your clergy person. Remember that in an emergency, your document needs to be quickly retrieved. Making it accessible means either giving each person a paper copy or giving them access through on-line storage. Through the Secure Directives Access service, you can give authorized access to those you choose.

What is advance care planning?

it refers to anticipating and deciding on possible medical decisions before you are unable to make your own healthcare decisions. By planning in advance, you are able to determine your wishes for care based on your values, beliefs and priorities. Discussing your preferences for treatment choices with your loved ones and your healthcare professionals, before there is a crisis, assures your wishes can be followed. Recording your wishes in writing a health care directive places them in a legal document.

Who decides if I am competent to make my own decisions?

Generally, if there is doubt about your ability to make your own decisions, your doctor and one other physician or licensed psychologist will evaluate you and certify in writing that you are – or are not – able to make or communicate your own healthcare decisions. Requirements for certifying your ability to make decisions may vary by state.

What happens if I don’t have a health care directive? Who makes the decisions?

Laws differ by state. In some states, the doctor can decide who should act as your healthcare agent. In some cases, the doctor or a hospital administrator can make the decisions for your healthcare.

However, in most cases, if you do not appoint a healthcare agent and a court has not appointed a guardian, then a relative can step forward and ask to become your agent. The priority for healthcare agents is generally:

  • Spouse
  • Adult child
  • Parent
  • Adult brother or sister
  • Adult grandchildren
  • Close Friend

If no one is available to act as your agent, your healthcare provider may ask a court appoint someone.

What if my doctor disagrees with my wishes?

If a doctor or hospital does not want to follow the directions spelled out in your directive, they must see that you get to a doctor or hospital that will follow your directions. Note that your state or hospital may have specific rules and procedures regarding end-of-life decisions. When you complete a directive through MyCare Directives, you may specifically request that the spirit of your preferences be honored if your instructions cannot be followed due to state or hospital rules.

What if I change my mind about my wishes and want to change my directive?

You can change your directive at any time. However, it is extremely important that you destroy all previous versions and copies. Instruct your loved ones, healthcare agent, physician and others to destroy old versions and replace them with your most current version. Using on-line storage and access can make this easier to manage.

Why does having a health care directive matter?

It provides peace of mind for you, because your wishes will be followed, and for those who will be asked to make decisions on your behalf. They will know your preferences instead of having to guess about the care you would want to receive. In addition, a health care directive can prevent unwanted medical services that run up the cost of care and deplete family resources unintentionally. For these reasons, a health care directive is a loving legacy.