April 16 – April 22 is National Health Care Decisions Week. The purpose of this is to inspire, educate, and empower the public and providers about the importance of advance care planning. This begs the question- what is an advanced health care directive, and who needs one?
Simply, an advanced health care directive is a written document that states a person’s wishes for how certain health care decisions should be made for them in the event that person is unable to speak for themselves. Every person over the age of eighteen should have this document. This is essential.
If you do not have an advanced directive in place, two things will likely happen. First, a person other than you will be making critical health decisions for you. These decisions include what kind of medical treatment you will receive (i.e., whether you would like to receive artificial nutrition, whether you are for or against organ donation, and more). Who is this person that will be making these important decisions for you? If you do not name someone, the law chooses someone for you, by default. If you are married, this will be your spouse. If you are not married, then a majority of your adult children. If you have no adult children, this will be your parents, if living (no matter if your parents are married or divorced). Consider the tension if your spouse makes a decision regarding your health care that your family disagrees with. Or, consider the possible tension between your adult children in trying to agree on a majority decision. Not to mention, the possible tension between a divorced mother and father trying to make these tough decisions for their young adult child.
This leads into the second thing that will likely happen if you do not have an advanced directive: your family will be put in a position to make their best guess as to what you would want to happen. At worst, your family may have no idea regarding your wishes, and may be in conflict with one another during an already incredibly difficult time. At best, your family may think they know your wishes and carry them out. Even so, when faced with a very difficult choice, they likely would have been comforted to have your decisions clearly laid out in writing for them, eliminating any doubts or confusion.
Some people avoid creating an advanced directive because they are not familiar with the advanced directive options. An advanced directive lays out a person’s thoughts on life sustaining treatment. Generally, the options fall into three broad categories; however, a person can always be more specific and personalize their wishes. (1.) Some people firmly state they want absolutely no life sustaining treatment, even if such treatment were able to bring them back to their existing quality of life. Those who choose this option may be significantly advanced in years, sometimes are chronically or terminally ill, and are often not currently experiencing a robust quality of life. (2.) Some people state that, if their medical team reasonably believes that temporary life sustaining treatment can bring a person back to their normal quality of life, then that person is in favor of receipt of such treatment. However, if they are not expected to resume a normal quality of life, they would not want their state of being (perhaps a vegetative state, or other state of illness or unconsciousness) to be prolonged by artificial means. For example, if a typical healthy young adult was in a car accident and needed treatment, including life sustaining treatment in the hospital, but were expected to regain his/her normal quality of life, he/she may want that medical treatment. Yet, the same young person may not be interested in living the remainder of their life in that hospital room breathing with assistance of a ventilator, or living dependent on other machines or devices. (3.) Some people do want any state of being, even a vegetative state, to be prolonged by any means necessary, including artificial nutrition, etc. Some write into their advanced directives a certain timeline. For example, a person may say- “If I have not improved within ninety days, please remove all artificial life sustaining treatment.”
Advanced directives also lay out a person’s views on organ donation- for or against, for transplant only of for all purposes, etc. If you are in favor of organ donation, you can also sign up online to be a registered donor through Donor Network of Arizona (https://www.dnaz.org/).
Additionally, advanced directives can state any specific religious objections to certain medical treatments, such as blood transfusions.
Any person over the age of eighteen should create an advanced directive that reflects his/her personal wishes. Your family will thank you for making your personal wishes clearly known, eliminating confusion, and minimizing tension. You can rest easy knowing that your wishes will be carried out.
-Megan Selvey, Esq.