Advanced Health Care Directive

The Advanced Health Care Directive ("AHCD"), which is also known as a living will, is a written statement that outlines whether or not your life should be prolonged by the use of artificial means in the event that you are incompetent and have a terminal condition or are permanently unconscious. This statement informs those you love of your desires and instructs your doctors and other health care providers to medically withhold specified care or to prolong the process of your dying. The AHCD should contain specific directions describing the kinds of life-sustaining medical treatments. and procedures you desire to be initiated, continued, withheld or withdrawn.

The use of an AHCD is limited to decisions about life-sustaining procedures. This differs from a Health Care Power Of Attorney, which establishes a person to act as your agent in all health care decisions. Please go to the document called Health Care Power of Attorney to learn more about its features.

What Are The Benefits Of An AHCD?

•   You retain control of future medical decisions.

•   Helps ensure that your wishes are respected in situations where you can no longer make those decisions for yourself.

•   Diminishes the anxiety of those who must make critical decisions on your behalf and gives them confidence that they are doing what you would want them to do on your behalf.

•   If you should suffer a progressive illness, an AHCD will reduce your anxiety by reducing the fear that inappropriate and unwanted medical treatment will be forced upon you as your disease progresses.

•   Reduces family discord among those involved in decision making by giving greater clarity about your wishes.

•   Provides opportunities for families and loved ones to talk together about your feelings, hopes and fears as you face catastrophic illness.

What Are The Limitations Of An AHCD?

•   An AHCD will not cover all situations.

•   Your feelings about future medical decisions while you are healthy may be quite different than when you are suffering from a terminal condition.

•   Your circumstances may change.

Who May Make An AHCD?

Generally, any competent adult of sound mind may make and sign an AHCD. However, state laws do vary. For instance, in Pennsylvania the law is more liberal, permitting any individual of sound mind, who is at least 18 years of age or who has graduated high school or who is married, to make and execute an AHCD.

Can Someone Else Make Decisions For Me?

If you wish, yes. You may name a "surrogate" and a substitute surrogate to make medical decisions for you if you should ever become incompetent and either in a terminal condition or permanently unconscious. However, the preferred procedure is to make your wishes known in an AHCD and to name a surrogate in that document instructing him/her to make sure that your written wishes are carried out. Before naming a surrogate, make sure that he/she is willing to fill this role and understands your preferences and desires.

When Does An AHCD Become Operative?

Your AHCD becomes operative when a copy is provided to your attending physician AND when you are determined by your attending physician to be incompetent and in a terminal condition or in a state of permanent unconsciousness. Once the AHCD becomes operative, your attending physician and other health care providers will act in accordance with its provisions or transfer you to a physician who will follow your directives if your attending physician is unable to do so.

How Can I Make Changes To My AHCD?

You may revoke or make changes to your AHCD at any time, regardless of your physical or mental condition. This may be done either in writing or by orally communicating your desire to your attending physician or other health care provider.

What Should I Do Once I Sign My AHCD?

Copies of your signed and witnessed AHCD should be given to your physician, agent/surrogate, lawyer and family. Your physician will make your AHCD part of your medical records.