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Advance Directives


Advance Directives are documents that inform your doctor and loved ones about what kind of health care you wish to receive, including legal documents about who serves as your healthcare proxy, should you not be able to make medical decisions for yourself. They should clearly describe what kind of care you want if you have an illness that you are unlikely to recover from or if you are permanently unconscious. Advance Directives usually specify that you don’t want certain kinds of treatment and can also say that you want a certain treatment no matter how ill you are. 

  • A Durable Power of Attorney (DPoA) (aka Medical Power of Attorney (MPOA) or healthcare proxy) for healthcare is a legally binding document stating whom you have chosen to make health care decisions for you should you become unable to make medical decisions. **This may be especially important for members of the LGBTQIA+ community: unless a DPoA is in place, decision making may default to next of kin.**
  • A Living Will describes which treatments you would or would NOT want if you're terminally ill or permanently unconscious. These could be medical treatments or treatments that will help you live longer. **Please note that a Living Will does not let you select someone to make decisions for you, and is not a legally binding document- your DPoA or healthcare proxy may have to strongly advocate for your wishes around life support options, and healthcare providers can legally act in opposition against your healthcare wishes.**
  • DNR (Do Not Resuscitate) orders are binding medical orders that apply only to cardiopulmonary resuscitation (CPR), instructing medical staff not to administer chest compressions. Doctors and hospitals in all states accept DNR orders, which do not have to be part of a living will or other advance directive. Choices about CPR have complexities to consider.
  • Other topics to address in an Advance Directive might be:
    • How much information you want about your prognosis or condition
    • AND (Allow Natural Death) orders, i.e. ensuring that only comfort and pain control measures are provided, with the withdrawal of nutrition and hydration, to allow the dying process to occur as comfortably as possible
    • Ventilation, i.e. whether or for how long you want a machine to take over your breathing, or having a DNI (Do Not Intubate) directive, where chest compressions or cardiac stimulants may still be used but no breathing tube will be placed
    • Tube feeding, i.e. whether or for how long you want to be fed through a tube in your stomach or through an IV
    • Palliative care and palliative sedation directices
    • Medical Aid in Dying or Death with Dignity options, which vary by state
    • Organ donation wishes
    • Voluntarily Stopping Eating & Drinking (VSED), especially in cases of late-stage dementia or paralysis due to stroke or Amyotrophic Lateral Sclerosis (aka ALS or Lou Gehrig's disease)
  • A POLST (Physician Orders for Life-Sustaining Treatment) form provides medical orders to emergency personnel based on your current medical situation. It represents an agreement between you and your care providers: your doctor or nurse must sign this form for it to be valid.

To help get you started: