Who Will Decide? Advance Directives for Health Care

May 25, 2018

It’s never fun to think about, but people get sick and injured – and even the healthiest of us will one day need to consider end-of-life medical decisions. In the event that you are unable to make these decisions for yourself, who will make them for you?

Advance directives for health care give specific instructions about your medical care in the event you are unable to express your wishes. An advance directive has two components:

  • Durable power of attorney for health care (DPOA) – authorizes an individual to consent to, stop, or refuse most medical treatment on your behalf.
  • Health care directive¬†– expresses your decisions for certain life-sustaining care, such as CPR, ventilator use, artificial nutrition/hydration, and comfort care.

There are many different types of health care directives, some more specialized than others. The most common directives are the living will, DNR, and POLST.

A living will is a legal document that spells out end-of-life care wishes and gives instructions for which life-saving treatments are to be provided or declined if you become terminally ill or permanently unconscious.

A DNR, or Do Not Resuscitate order, is signed by your physician and tells health care providers not to perform CPR or other life support procedures (per your choosing) during cardiac or respiratory arrest. In the absence of a DNR, medical personnel will use all appropriate life-saving measures.

A POLST form, or Physician Orders for Life-Sustaining Treatment, is a standing medical order for specific treatments to be given during a medical emergency. POLST forms are indicated for people with advanced terminal illness or age, who know specific medical decisions that might need to be made for them. This form is filled out by your physician and a copy is kept in your medical chart and filed with your local hospital.

You can usually find the advance directive forms you need at your physician’s office, which is the best place to start the discussion. Your health care provider can help you identify and understand issues that may arise in your individual health journey, so that you can make informed decisions. In Washington, most forms do not need to be notorized, but many do need to be signed by two witnesses; some, like the POLST, must be filled out entirely by your physician.

Having an advance directive for health care in place is one of the best things you can do for yourself and your loved ones. It’s important for all adults, even if end-of-life decisions seem impossibly far off. As your life changes, so can your directive – you can change or revoke it at any time. It’s YOUR health, take charge!