Imagine, if you suddenly lose consciousness due to an accident or a serious illness, or if you are in a situation where you are unable to make decisions for yourself... Who would make decisions about your treatment and your medical affairs at such a time? This is not something that any of us like to think about. But, life is very unpredictable. Therefore, how valuable is it to be informed in advance about how our medical care should be carried out if we are unable to make decisions while we are still conscious?
Simply put, this is what we call an " advance directive ." This is not just a piece of paper. This document becomes your voice when you can't speak. It frees your family and doctors from a lot of responsibility and gives them the guidance to do everything according to your wishes.
What are the main types of Advance Directives?
When creating an Advance Directive, there are a few main areas we need to consider. Sometimes these can be separate documents. Let's take a look at what they are.
| Type of document | Simply put... | For example |
|---|---|---|
| Living will | Writing down in advance what medical treatments you should or should not receive in case you are unable to make decisions. | "If I am suffering from a terminal illness, please do not use ventilators just to postpone my death." |
| Health Care Surrogate/ proxy | Empowering someone you trust to make medical decisions for you when you are unable to make decisions. | You can delegate this authority to your partner, a child, or a very trusted friend. This person is the one who talks to doctors on your behalf and approves or rejects treatments. |
| Durable Power of Attorney | This is not limited to medical matters. Authorizing someone to handle your financial affairs (e.g., paying bills, banking) if you are unable to do so. | While you are unconscious in the hospital, the person you have authorized will be able to pay your household bills and sign checks in your name. |
Things to keep in mind when preparing these documents
Although creating a document like this may seem simple, there are several things we need to consider in order for it to work properly.
1. Ambiguity of words
Often, the words used in documents like `Living Wills` can have different legal and medical meanings. For example, there can sometimes be different opinions even among doctors about the definition of ``terminal condition.`` Similarly, when we talk about ``artificial procedures,`` there can be debates about what is included and what is not.
Therefore, it is important to be as specific and clear as possible in your wishes. Rather than writing something general like "No life-prolonging treatment," it is much more important to be specific, such as "I do not want to have feeding tubes inserted" or "I do not want to be connected to a ventilator."
2. Choosing a Surrogate
Perhaps the most important thing is to appoint someone to make decisions for you. It's not enough to just choose someone you love very much. That person needs to have a strong personality .
Imagine that you have already written that you do not want a certain treatment. But a doctor comes to your representative and says, "Let's try this treatment, maybe it will make a little difference." At that point, you should choose someone who, while respecting the doctor's opinion, can firmly say, "No, this is what he wanted. We have to respect that." It is also essential that that person understands 100% of what your wishes are.
So what should we do?
With all of this, if you want to make a plan for your future, it is very important to follow these steps.
- Talk to your doctor: This is the first thing you need to do. Start a conversation with your doctor right away. Be open about what your wishes are, what your fears are, and how you want to spend the last days of your life . Then, when the time comes, he or she will have a clear understanding of your wishes.
- Choose a trusted representative: As we discussed earlier, choose someone who truly understands your values, beliefs, and outlook on life, and who can stand up for you when needed. Once you've chosen one, talk to them about this in detail.
- Make the document clear: It's best to get the help of a lawyer. Use as specific words as possible and write to eliminate any ambiguity about what your wishes are.
- Inform your family: After you have prepared this document, inform your family (especially your closest ones) about it. Explain to them in a loving way why you have made this decision. This will help to avoid any conflicts between them in the future.
Although this is a sensitive topic, planning ahead in this way can give you and your loved ones a lot of peace of mind. It's like closing your doors and windows before a storm hits and making sure you're safe.
Take-Home Message
- An Advance Directive is a legal document that states your wishes for medical treatment in advance in the event that you are unable to make decisions.
- The main types are Living Will (a will for treatment), Health Care Surrogate (appointing someone to make decisions for you), and Durable Power of Attorney (delegation of authority for financial matters).
- When drafting your document, be as clear and specific as possible. Instead of using general terms, state exactly what treatments you want or don't want.
- The person appointed to make decisions for you (Surrogate) should be someone who knows your wishes well and can strongly advocate for them.
- Before all of this, talk openly about this with your doctor and clearly state your thoughts and wishes.
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