An advance directive helps your loved ones

By Judy Fortin
CNN

Adjust font size:

(CNN) -- It's not easy making decisions about end-of-life care. An advance directive may help ease the burden. It's a legal document that conveys your specific wishes regarding your care.

Advance directives are often called by other names, usually a living will or a health care power of attorney.

A number of Web sites offer step-by-step guides involving some tough choices regarding life support and resuscitation. You don't need a lawyer to complete an advance directive. It's legally binding once you've signed it in front of witnesses, who also sign.

CNN Medical Correspondent Judy Fortin learned more about advance directives from Dr. Wendy Wright of Emory University Hospital in Atlanta, Georgia.

Fortin: What is an advance directive and who needs it?

Wright: An advance directive is basically a written statement about how a person would like to be treated if they become unable to make medical decisions. Most people probably need an advance directive.

Fortin: What is a living will?

Wright: A living will often just indicates if a person would want to be kept on life support or if they would want artificial nutrition or hydration. It's important for people to understand that if they make those decisions known ahead of time then their specific wishes can be more easily followed.

Fortin: What is a health care power of attorney?

Wright: Oftentimes, these advance directives may appoint a health care power of attorney. It says, this is the person who will make decisions for me if I'm incapacitated. In most cases, and this depends on state law, if a patient is married, their spouse will automatically be the decision-maker. Durable health care powers of attorney are appointed in the case of someone who is not married.

Fortin: It sounds like you're asking people to make hard choices ahead of time.

Wright: It's an extremely hard choice and that's why the choices are so individualized. Some patients may be perfectly happy as long as they were able to regain consciousness and recognize their family members and enjoy their family members' company. Some patients wouldn't be happy unless they could be completely independent.

Fortin: Do your choices have to be written or could you just tell someone what you want?

Wright: It's better to have it written down in a legal document. If there is any confusion or conflict among family members or friends they can turn to the document.

Fortin: What happens if someone doesn't have an advance directive?

Wright: I am put in the position where I provide every life sustaining measure possible, which may sound appropriate for all patients but it's not always. If I have a very elderly or frail patient whose heart is about to give out, and then their heart stops, by default I must run in and do all the things you see on television, the electric shocks, the chest compressions. It often can break ribs. Many times we can't get the heart re-started. To put an elderly patient in that position when what they really could have had was a gentle, peaceful death is not always appropriate.

Fortin: Can you change your mind about your advance directive?

Wright: Absolutely, you can change your mind at any point. You can rescind any part of your advance directive. You can change your decision-maker and your health care power of attorney as long as you are conscious

Judy Fortin is a CNN Medical News correspondent.

Tools:
Save |
Print |
E-mail |
Most Popular |

Next story in Health

Health

What are E-mail Alerts? | Manage Alerts | Create Your Own

Jackson death probe may turn criminal, LAPD says

The Jackson family knows that the probe into singer Michael Jackson's death could turn into a criminal case, a source close to the family told CNN Thursday.