Why Have an Advance Directive?

Advance directives are an important estate-planning tool. The three most common forms of advance directives are durable powers of attorney for health care, living wills, and do not resuscitate orders. All three function to let family members and health care providers know a patient's wishes in the event he is unable to communicate or becomes incapacitated.

Making an advance directive gives many people peace of mind. Often, when a family member becomes terminally ill or incapacitated, other family members have the heavy burden of deciding on appropriate end-of-life care. Advance directives let family members and health care providers know exactly what types of medical procedures a patient wants administered or withheld, taking the responsibility out of the hands of others. Some people make advance directives because they fear becoming a financial strain on their families, as end-of-life care and prolonging death through medical procedures can be costly.

A durable power of attorney for health care gives others guidance as to what end-of-life procedures a patient wants. Unlike a living will, a durable power of attorney for health care directs a specific person — often called a health care proxy — to make decisions on the patient's behalf. Durable power of attorney documents typically direct a health care proxy to communicate to physicians exactly which end-of-life care to withhold or to have administered. Examples of end-of-life procedures include artificial respiration, hydration, nutrition and medicines that might suppress respiration and hasten death.

Living wills typically address many of the same things as a durable power of attorney for health care. The difference between the two is that living wills simply communicate the maker's wishes regarding end-of-life care. Living wills do not give power to another person to make decisions on the patient's behalf. Living wills merely communicate a patient's preferences regarding end-of-life medical procedures.

Do not resuscitate orders are another form of advance directive. However, do not resuscitate orders are more limited in scope. Such orders only address whether a patient wishes to have cardiopulmonary resuscitation (CPR) if he stops breathing or his heart stops. Without a do not resuscitate order, health care providers such as emergency medical technicians will administer CPR. As with living wills and durable powers of attorney for health care, give a copy of the do not resuscitate order to the patient's primary care physician.