Advance care directives
Definition
When you are very ill or injured, you may not be able to make health care choices for yourself. If you are unable to speak for yourself, your health care providers may be unclear as to what type of care you would prefer. Your family members may be uncertain or disagree about the type of medical care you should receive. An advance care directive is a legal document that tells your providers and others involved in helping you what care you agree to or decline in advance of this type of situation.
Alternative Names
Living will; Power of attorney; DNR - advance directive; Do not resuscitate - advance directive; Do-not-resuscitate - advance directive; Durable power of attorney - advance care directive; POA - advance care directive; Health care agent - advance care directive; Health care proxy - advance care directive; End-of-life-advance care directive; Life-support - advance care directive
Why Write an Advance Directive?
With an advance care directive, you can tell your providers what medical treatment you do not want to have and what treatment you want no matter how ill you are.
Writing an advance care directive may be hard. You need to:
- Know and understand your treatment options.
- Decide future treatment options you may want.
- Discuss your choices with your family.
Living Wills
A living will explains the care you do or do not want. In it, you can state your wishes about receiving:
- CPR (cardiopulmonary resuscitation) if your breathing stops or your heart stops beating
- Feedings through a tube into a vein (IV) or into your stomach
- Extended care on a breathing machine
- Tests, medicines, or surgeries
- Blood transfusions
Each state has laws about living wills. You can find out about the laws in your state from your providers, the state law organization, and most hospitals.
You should also know that:
- A living will is not the same as a last will and testament after a person's death.
- You are not able to name someone to make health care decisions for you in a living will.
Other Types of Advance Directives
Other types of advance directives include:
- Special health care power of attorney is a legal document that allows you to name someone else (a health care agent or proxy) to make health care decisions for you when you cannot. It does not give power to anyone to make legal or financial decisions for you.
- A do-not-resuscitate order (DNR) is a document that tells providers not to do CPR if your breathing stops or your heart stops beating. Your provider talks to you, the proxy, or family about this choice. The provider writes the order on your medical chart.
- Fill out an organ donation card and carry it in your wallet if you wish to be an organ donor. Keep a second card with your important papers. You can find out about organ donation from your provider. You can also have this choice listed on your driver's license.
- Verbal instructions are your choices about care that you tell providers or family members. Verbal wishes may replace those you made previously in writing.
Additional Information
Write your living will or health care power of attorney according to your state's laws.
- Give copies to your family members, providers, and health care agent.
- Carry a copy with you in your wallet or the glove compartment of your car.
- Take a copy with you if you are in a hospital. Tell all medical staff involved in your care about these documents.
You can change your decisions at any time. Be sure to tell everyone involved, family members, proxies, and providers, if you make changes to your advance directive or a living will is changed. Copy, save, and share the new documents with them.
References
Lukin W, White B, Douglas C. End-of-life decision making and palliative care. In: Cameron P, Little M, Mitra B, Deasy C, eds. Textbook of Adult Emergency Medicine. 5th ed. Philadelphia, PA: Elsevier; 2020:chap 21.
Rakel RE, Trinh TH. Care of the dying patient. In: Rakel RE, Rakel DP, eds. Textbook of Family Medicine. 9th ed. Philadelphia, PA: Elsevier; 2016:chap 5.
Review Date:1/18/2022
Reviewed By:David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997-A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
The Agency for Health Care Administration (Agency) and this website do not claim the information on, or referred to by, this site is error free. This site may include links to websites of other government agencies or private groups. Our Agency and this website do not control such sites and are not responsible for their content. Reference to or links to any other group, product, service, or information does not mean our Agency or this website approves of that group, product, service, or information.
Additionally, while health information provided through this website may be a valuable resource for the public, it is not designed to offer medical advice. Talk with your doctor about medical care questions you may have.
