Advance Directives Information Sheet

hat is an advance direc-

tive? An advance directive is a document that states your choices about medical treatment, and can name someone to make those decisions for you if you are unable to make them yourself. That person is commonly referred to as a healthcare proxy or medical power-of-attorney. You can also create a living will (not to be confused with a will used after death) which is also an advance directive wherein you can indicate what type of medical treatment you want or don’t want at the end of life or in an emergency situation.

Usually when you have a conversation with your doctor about medical treatment, you ask questions and get as much information as you can in order to make a decision based on informed consent. If you are ill or injured and cannot have those conversations, it is important that you prepare in advance to appoint someone to do that for you. It is a good idea to put your wishes in writing which will help ensure that your choices concerning medical treatment will be observed.

Who can have an advance directive? Anyone who is age 18 or older. Once you are of legal age to make your own decisions, you can have an advance directive because injuries, accidents and illness can happen at any age.

Who can make an advance directive? An advance directive can only be made by someone who is competent, and it must be made voluntarily. Note that you cannot “get powerof-attorney over someone”. Only the individual can appoint their own medical decision-maker.

Who should I appoint to be my decision-

maker? You should appoint someone you trust and know will make decisions based on your values, goals, and preferences. Choose someone you know will do what you want and follow your wishes. This could be a family member, friend or trusted professional, such as an attorney, but make sure you get their consent, and they are aware you are making the decision. It shouldn’t be a surprise to the person you appoint, as they should know what your wishes are and be agreeable to act in that capacity.

Who will make medical decisions for me if I

don’t have an advance directive? Your guardian, (if appointed by the court), your spouse, adult children, parents, siblings or a friend, if available. Unfortunately, that person may choose to do something other than what you want, and you may end up receiving more or less treatment than you would have preferred. Again, your best option is to have those choices in writing, although they can be made electronically or in person with your physician.

RESOURCES

Maryland Attorney General Advance Directive: www.marylandatto rneygeneral.gov

The People’s Law Library: www.peoples-law.org/ advance-directives

American Bar Association, Toolkit for Healthcare Advance Planning: www.americanbar.org

www.eforms.com/ power-of-attorney/ md/

Maryland State Anatomy Board: 410-547-1222

Anatomy Gifts Registry:

800-300-5433

Does an advance directive need to be nota-

rized? No, according to the Maryland Attorney General’s Office, a written advance directive must be witnessed by two adults. Neither of the witnesses may be the person’s health care agent, and at least one witness must have no financial interest in your death.

What is a psychiatric advance directive? A psychiatric advance directive is a written statement that documents your preferences for future mental health treatment, and allows appointment of a health care proxy to interpret those preferences during a crisis (National Resources Center on Psychiatric Advance Directives). It can include your preferred mental health providers and facilities, and can also include preferred treatment medications.

Can I include organ donation in my advance

directive? Yes. There is a need for organ donation, and your age does not matter, but you must make arrangements in advance with the Maryland Anatomy Board, or a non-profit organization such as the Anatomy Gifts Registry (see the “Resources” section for contact information).

Do I need to hire an attorney to prepare my

advance directive? No, it is not necessary, but if you prefer to do so, someone experienced in estate planning or elder law is a good choice. There are several good websites that offer the forms and instructions on how to complete them (see the end of this article), and see your healthcare provider if you have medical questions about your decisions.

What should I do with my advance directive

once it has been completed? Give a copy to your health care proxy, your alternate if you have named one, and your healthcare providers. If you live in an assisted living or nursing home, make sure they have a copy in your file or chart. You may also give copies to those individuals that are close to you.

How often should I update my advance direc-

tive? It’s a good idea to review it annually to make sure the choices you make are still in line with your beliefs. It is also a good idea to review it if there has been a major medical change in your condition or a decline in your health. You want to make sure your healthcare power-ofattorney is still available, willing, and capable of acting in that capacity.