What Are Advance Directives

What Are Advance Directives

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What Are Advance Directives

Advance directives are legal forms and documents that provide individuals with opportunity to detail their wishes, generally regarding medical treatment and life extending treatments, so that their desires are upheld in the event that he/she sustains a debilitating injury that hinders his/her ability to effectively make decisions for himself/herself. When an individual has completed the necessary processes to establish advance directives, medical professionals are required to adhere to these legal documents.

Therefore, if an individual creates a Do Not Resuscitate order, doctors, nurses, and paramedics will be legally bound to respect the parameters of this document and will not be permitted to initiate CPR. If an individual chooses to establish advance directives, he/she should be sure to be extremely specific and detail every procedure and treatment that he/she will accept, as well as those he/she would not want to be subjected to.

Background

With advances in modern technology, it is now more important than ever for an individual to ensure that his/her wishes are well documented, especially regarding his/her health care and medical treatment. Groundbreaking medical treatments have given medical professionals the ability to significantly extend life, even for patients who have been diagnosed with illnesses that were once considered terminal.

While this is generally considered to be a positive feature of health care, technological advances are often utilized to lengthen the life expectancy of individuals who are suffering from excruciating pain, thereby extending the period of their suffering without offering them a cure for their condition. While many patients will accept this regardless of any discomfort that may be associated, some individuals do not wish to continue living if their quality of life will be substantially decreased.

Advance directives provide individuals with the ability to express their desires in a legally binding document which medical professionals will be obligated to satisfy. 

Living Wills


Each individual maintains different mentalities and beliefs regarding life support and life-prolonging treatment. While some individuals may expect medical professionals to attempt resuscitation and engage in extraordinary measures to extended his/her life, others do not wish to receive this treatment. If an individual is against obtaining some or all forms of life prolonging treatment, he/she should create a living will.

A living will is a legal document in which an individual can record his/her wishes in the event that he/she becomes unresponsive due to a terminal illness or a tragic accident. This will inform doctors and paramedics about a patient's wishes and desires regarding medical treatment and procedures. If a living will has been established, medical professionals must adhere to this legally-binding document. When an individual decides to create a living will, it is important for him/her to be extremely specific about the treatment and procedures that he/she will accept, and the medical attention that he/she does not want.

Durable Power of Attorney


It is important for individuals to complete all of the necessary steps to ensure that his/her wishes will be upheld in the event that he/she slips into a coma/vegetative state. In many cases, this will require more effort than creating a living will and signing a Do Not Resuscitate order. Some individuals choose to appoint a durable power of attorney.

An individual chosen to become a power of attorney will assume responsibility for ensuring that the appointee's wishes are upheld. A durable power of attorney is often required to make difficult decisions regarding appointee's fate. He/she may be required to decide when to halt life-prolonging treatment and cease life-sustaining procedures. The power of attorney will be obligated to advocate for the incapable individual and confirm that medical professionals are acting in accord with the desires previously set forth by the patient. 

Health Care Proxies

A health care proxy, like a durable power of attorney, plays an important role in ensuring that an individual's medical wishes are upheld if he/she becomes incapacitated or unable to speak for himself/herself. An individual who is appointed as a health care proxy will maintain the same fundamental responsibilities as a durable power of attorney.

He/she will be granted extensive power and authority over any decision related to the appointing individual's health care. Therefore, it is essential for an individual to designate an individual that he/he trusts to assume the responsibility of carrying out the duties of a health care proxy. A health care proxy should be an individual who is reliable and responsible, as well as someone who is close to the appointing individual.

Once an acceptable health care proxy is chosen, it is important for an individual to thoroughly discuss all of his/her desires and feelings, as they relate to life support and life-extending treatments. A health care proxy should be sure about all of the treatments an individual would disapprove of, as well as which ones he/she would accept.

Guardians

Guardians are individuals who become legally responsible for the care of another human being. Guardianship becomes extremely important in the event that an individual becomes seriously injured or incapacitated before he/she has appointed a health care proxy to advocate for his/her wishes regarding medical treatment.

In the event that vital medical decisions must be made and nobody has been appointed to address these decisions, a judge will appoint a legal guardian. Once appointed, a guardian will obtain the responsibility of making all of the decisions related to his/her ward's health care and medical treatments. This may include deciding whether or not to initiate or intervening treatments.

If a family member or a friend feels that he/she is best suited to take on this role, he/she may choose to petition a court for guardianship rights. If there is a dispute or conflict over guardianship rights, a guardian ad litem may be appointed to make any immediate and necessary decisions while the judge attempts to determine who would make the most effective guardian.

"Do Not Resuscitate" Orders


If an individual suffers from respiratory failure or cardiac arrest, medical professionals will likely attempt to resuscitate him/her using cardiopulmonary resuscitation, or CPR, an emergency technique that restarts circulation and breathing. However, many individuals do not wish to be resuscitated once they stop breathing.

There are many factors that may influence an individual to obtain a Do Not Resuscitate order. These legal documents are most commonly petitioned for by elderly individuals entering a hospital for surgical procedures or by individuals suffering from a terminal illness. In these instances, resuscitation would continue to prolong an individual's pain and suffering. Often, when an individual experiencing these conditions is resuscitated, his/her quality of life will be greatly diminished. Therefore, many individuals will obtain A DNR order to inform medical professionals that they do not wish to be revived.

An individual may obtain this document if he/she is entering a hospital for medical treatment, or if he/she wishes to display the document in his/her home to inform paramedics should they be required to respond at his/her home.

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