Advance Directives

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Advance Directives

Health care advance directives (a living will and a durable power of attorney) are two basic and very important legal documents for communicating an individual’s wishes concerning the decision-making regarding his/her health care in case if the individual becomes incapable of making such decision him/herself. These documents protect the interests of demandants from a legal viewpoint. However, their ethical essence is still disputable. Despite the obvious advantage (honoring the wishes of demandant) there are feelings of family members that may not be agreeing with advance directives.

Living Will

A living will is a legal writing that contains an individual’s wish for his/her medical care in case if the person becomes incapable of making decision on his/her own. In many states, a living will is also called a declaration or a medical directive. It is called a “living” will because it comes into operation while an individual is still alive; its focal point usually concerns not only the aspect of ending life, but also any other aspects of treatment can be commanded (Buchanan, 1990). For living wills to come into force the person has to have a terminal condition or be in the state of permanent unconsciousness, therefore being incapacitated of making sound or any decision. Some states of the U.S. also acknowledge end-stage conditions (for instance, advanced Alzheimer) or any other ones appointed in the living will. To be legally valid, a will has to be composed in accordance with the state’s law requirements regarding the rules of content, signing and witness certification (Olick, 2001).

Some people prefer death over being everlastingly chained to the medical equipment or not being able ever to have an accustomed quality of life. Others are just as strongly convinced that with the help of technologies they have the opportunity to live until the medicine will invent the cure from their condition. Therefore, a living will allows individuals to fulfill their wishesin relation to their further treatment while they are not capable of doing so on their own. Moreover, it is delivering their family and friends from making difficult decisions. 

Durable Power of Attorney for Health Care

A durable power of attorney is a legal writing, in accordance with which one individual (the grantor, donor or principal, the name depends on the state law) trusts another one (the proxy, agent or representative, the name depends on the state law) to make a decision about the course of medical treatment. The writing comes into force when the principal is not capable of making decisions on his/her own. The document gives the agent the rights of visitations as well as access to all necessary medical information (Buchanan, 1990).

The person that is trusted to make a decision on behalf of the principal must be selected very carefully. It has to be a person who will act in the best outcome for the principal regardless of his/her beliefs or feelings. For instance, choosing a spouse to be an agent is not a wise decision. The agent should not be of any radical believes such as obligatory medical interventions or unacceptance of medical interference. A good choice is a trusted friend, colleague or counselor; even more perfect the one with medical knowledge (Cantor, 1993). Principals have to discuss their wishes with agents because those will need all guidance possible while making a decision. The principal of sound mind and memory has every right to abrogate the given power at any moment. The different states have different rules of validation for the durable powers of attorney. Most states specify two certified witnesses; however, some states allow the notarial attestation of the power of attorney as an alternative (Olick, 2001).

The durable powers of attorney and living wills are important for people of any age because nobody is ensured from unfortunate accidents. They are the only way, outside of a court of law, to ensure that the individual’s personal interestts will be taken into account. These documents express strong and informed opinion and commitment of the individuals to be treated in a certain way at the moment when they will not have a decisive voice.

The Living Will

To my family, medical care providers and hospitals:

I __________, being of sound mind and memory and following my own free will and understanding write this will to give directions if I happened to be incompetent of making a decision on my own. Thus, I express my legal right to reject medical care under the circumstances stated hereinafter. I trust the below-indicated parties to act in accordance with my wishes.

Directions:

I wish in case when I am terminally ill and in nonreversible comatose or continual vegetative state that directions listed below be followed:

  1. I want a health care essential to keep me comfortable. However, I refuse the following:

a) Any kind of mechanical ventilation;

b) Cardiopulmonary resuscitation with the help of any drug or electric shock.

c) Tube feeding including food and fluids;

d) Dialysis;

  1. At the same time, I wish to use the all possible medical or scientific methods and instruments to cure my condition until it will not be reasonably decided by council of physicians that my condition is incurable or irreversible.

Witness’ statement:

I confirm that the individual that executes this document acts voluntary and he/she is signing the Living Will in my presence, and he/she is of sound mind and memory and not being  under any stress, deception, or undue influence of any substances or people. (Name, Signature and Address of Witness).

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