Myth: Some states in the U. S. do not recognize advance directives.
Fact: Advance directives are recognized in all 50 states. However, states differ regarding requirements such as number of witness or necessity of a notary. Some states maintain registries that allow quick access by agents and healthcare providers.
Myth: Advance directives should be kept in a safe deposit box with other important papers. Fact: A copy of your ADs should be readily available at home. Patients should also give a copy to their physicians and proxy( agent). It is a good idea to make extra copies in the event you need to be admitted to the hospital.
Myth: With an advance directive in place, the person gives up control. Fact: Drawing up an advance directive gives you the opportunity to decide, state, and put in writing the end-of-life care you want, thereby helping your agent represent your choices when the time comes.
The Basics
So, what are advance healthcare directives? They are documents designed to ensure that a person’ s wishes— to accept or refuse treatments— are met through written directives. Healthcare institutions( hospitals, home health, nursing homes, etc.) are legally obligated to: 1) ask patients if they have advance directives, and 2) provide information and education about advance directives. It is up to each one of us to decide, while we are well and capable, how we will want unexpected medical events to be handled. By exercising our freedom to decide for ourselves our fate or the course of actions, we greatly decrease the chances of an arbitrary exercise of outside authority in determining our futures. Our aim in having ADs is to give us maximum control of our lives and our futures, and to provide peace of mind to our loved ones.
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Making healthcare decisions involves trying to understand a lot of information that may be confusing, daunting, and scary. There are multiple issues to consider and a variety of documents to obtain, draw up, sign, and periodically review. The definitions and explanations below present an overview of the documents and will help you decide which ones are pertinent for you. The Resources section below will guide you to more detailed information and next steps.
Values History
A Values History Form is designed to help individuals reflect upon their own personal value system before and while making healthcare decisions. Approaching advance directives from a values perspective enables people to make healthcare choices in line with their values. The intention of a Values History is not only to help an individual understand their own wishes regarding advance care planning, but also to convey one’ s ethics, views, and principles to family members. In that spirit, values questions include topics such as your overarching attitude or philosophy toward life and health, your goals, what makes your life feel worthwhile, what you fear, what you enjoy, your current health and health challenges, your views about independencedependence, your role in significant relationships, your spiritual or religious beliefs and how those affect your feelings about illness, your attitudes and relationships with your healthcare providers, and more.
Examples of different Values forms include:
• Values History from the University of New Mexico Center of Health Law and Ethics
• Ethical Wills: A Modern Jewish Treasury edited by Jack Riemer and Nathaniel Stampfer( Schocken Books)
• Ethical Wills & How to Prepare Them edited by Jack Riemer and Nathaniel Stampfer
• Ethical Wills: Putting Your Values on Paper by Barry K. Baines, MD