Imagine if you suddenly became seriously ill, or had an accident and lost consciousness... God forbid that should happen to anyone! But, what if you were unable to tell the doctors and your family what treatments you wanted and didn't want? Who knows what your wishes would be at a time like this? This is a topic that none of us like to think about. But, how much peace of mind would it bring to you and your loved ones if you had thought about this and planned it in advance when everything was fine? That's what we're talking about today, the 'Advance Directive'.
What exactly is this Advance Directive?
Simply put, an Advance Directive is a legal document that tells your doctors and family in advance what medical treatments you want and don't want if you become incapacitated. It's like your future 'voice of the doctor'.
This document allows you to state in advance what treatments you like and dislike. It also gives you the opportunity to name someone who can be responsible for ensuring that your wishes are met.
This is not something that is only for the elderly or those with serious illnesses. Any healthy adult can prepare a document like this. Because things like illness and accident don't come with age.
Therefore, it's best to complete something like this while you're healthy and sane. It's like an investment in your future health.
What are the main types of Advance Directives?
There are several main types of Advance Directives. Let's simply understand each one.
| Directive Type | Simple explanation |
|---|---|
| Living Will | This means that if you have a terminal illness or if you become permanently unconscious, what treatment you should and should not receive. For example, this could include whether or not you should be connected to life support machines or whether or not you should be fed artificially. |
| Durable Power of Attorney for Healthcare | This involves legally naming someone you trust to make medical decisions for you if you are unable to make them yourself. This person is called a 'Healthcare Proxy' . It is very important that this person is someone who is very familiar with your wishes and values. |
| Physician Orders for Life-Sustaining Treatment (POLST) | This is a form that is usually filled out by a person with a serious medical condition, along with their doctor. It contains clear instructions on how medical staff should act immediately in the event of an emergency. It is not a replacement for other documents, but rather a clear medical order in addition to them. |
| Do-Not-Resuscitate (DNR) Order | This means that if your heart or breathing stops, do not attempt to perform cardiopulmonary resuscitation (CPR) . This decision is usually made by people who are in the final stages of a terminal illness. The doctor will discuss the pros and cons of performing CPR with the patient and family. |
Do I also need an Advance Directive?
Yes indeed! As we said before, this is not just something that applies to the elderly. Anyone can have an accident or illness at any age. What if you can't talk, what if you can't express your wishes?
Having a document like this in place while you are healthy will ensure that you receive the medical care you need when you need it. Not only that, but naming someone you trust to make decisions for you (a Healthcare Proxy) will also provide your family with a great deal of comfort during difficult times. Because they won't have to worry about "what kind of decisions would he or she make if he or she were here?" They can act on your wishes because they have your wishes clearly written down in a document.
What happens if an Advance Directive is lost?
Imagine that you do not have such a document, and you are also unable to make decisions. If so, who will make decisions for you? According to the law and common practice in our country, the responsibility for making those decisions usually falls on your spouse (husband or wife), parents, or adult children.
But what if your family disagrees about the treatment you should receive? One person says they want life support, while the other says they don't want to suffer like that. This can be a big problem. And the decisions they make at that time may not be what you truly want. An Advance Directive is important to avoid such confusing situations.
How do I make an Advance Directive?
This is not as complicated as you might think.
1. Think about your preferences: First, you need to think carefully about what you like and dislike under various medical conditions. It is very important to talk about this openly with your family and your doctor.
2. Prepare the document: Write your wishes clearly. Standard forms for this can be found online. However, it is important to prepare this in accordance with the legal framework of our country. Therefore, it is wise to seek the advice of a lawyer.
3. Sign and witness: After preparing the document, it must be signed and witnessed according to the relevant legal procedures.
4. Give copies: Give copies of this document to your family, your designated Healthcare Proxy, and your family doctor. Keep the originals safe with you.
The most important thing is that your family is aware of this document. If they don't know that such a document exists, it won't be useful in an emergency.
When does this document come into effect?
This is a question that many people ask. An Advance Directive only comes into play when you are unable to express your medical wishes. If you are of sound mind and able to speak, you make all the decisions for yourself.
There is another important thing. In the event of an emergency, emergency medical technicians (EMTs) cannot act on these documents. Their first responsibility is to stabilize you and admit you to the hospital's Emergency Treatment Unit (ETU). After you are admitted to the hospital, a doctor will assess your condition and confirm that you are not capable of making decisions. The Advance Directive will be implemented.
Can I change my Advance Directive?
Of course you can! You can revoke or change this document at any time, provided you are of sound mind and can clearly express your wishes.
In fact, it's a good idea to review your Advance Directive periodically, perhaps every few years, to see if what it says still fits your current wishes. If there are major changes in your life (e.g., marriage, divorce, having a child), it's also worth reviewing it at that time.
If you create a new document, it will automatically cancel the old one. Don't forget to give copies of the new document to everyone involved.
Thinking about an Advance Directive can be difficult, but it is a very valuable and wise decision you can make for your future and for the peace of mind of your loved ones.
Take-Home Message
- An Advance Directive is a legal document that tells you in advance what medical treatment you want in the event that you are unable to make decisions.
- This is very important to adjust for any healthy adult, regardless of age.
- Living Will and Durable Power of Attorney for Healthcare (naming a Healthcare Proxy) are the two main types.
- When preparing such a document, consult with your family, your doctor, and, if necessary, a lawyer.
- Once the document is prepared, give copies to your family, doctor, and the person you have designated, and keep them informed about it.
- You may change or revoke this document at any time, provided you are of sound mind.
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