Making informed decisions about your healthcare is a fundamental right. Doctors routinely discuss treatment options, risks, and benefits with patients to ensure collaborative decisions. But what happens if you become unable to make these critical choices yourself? An unforeseen accident or illness can leave anyone in a position where they cannot communicate their wishes regarding medical treatment. This is where advance directives become invaluable. They act as your voice when you cannot speak for yourself, ensuring your religious and personal beliefs are honored in your healthcare journey.
While no one is legally obligated to have an advance directive, creating one is a proactive and wise step for adults of all ages. It’s about planning for future healthcare needs and ensuring your wishes are respected. Without an advance directive, healthcare decisions typically fall to your next of kin. However, even if you trust your family to make these choices, an advance directive simplifies the process for your loved ones, preventing potential disagreements and misunderstandings during stressful times.
What can you accomplish with an advance directive? Primarily, it empowers you to:
- Appoint a Health Care Agent: Designate a person you trust to make healthcare decisions on your behalf if you are incapacitated.
- Outline Health Care Instructions: Specify the types of medical treatments you consent to or refuse, particularly concerning life-sustaining measures or end-of-life care.
Key Components of an Advance Directive
An advance directive typically encompasses two main parts:
Health Care Agent (or Durable Power of Attorney for Health Care): This is the individual you appoint to make healthcare decisions for you when you are unable to do so. This person, often a family member or close friend, acts as your advocate, ensuring healthcare providers adhere to your wishes. It’s crucial to choose someone you trust implicitly and have open conversations with them about your values and preferences.
Health Care Instructions (or Living Will): This section allows you to express your preferences regarding specific medical treatments, especially those related to life support, resuscitation, artificial nutrition, and pain management. It’s about outlining your wishes for care in situations such as serious illness or near the end of life. Consulting with your doctor can provide valuable insights into these treatments and help you align your choices with your personal beliefs and goals.
Alt Text: A family providing support and care, illustrating the importance of having a health care agent within an advance directive.
Creating Your Advance Directive
Preparing an advance directive doesn’t need to be daunting. Here’s a step-by-step guide:
- Initiate Conversations: Discuss your wishes with family members, close friends, your physician, or a religious advisor. Open communication ensures your loved ones understand your values and preferences.
- Seek Guidance and Forms: While some people consult lawyers, readily available sample forms can also be used. Numerous organizations, including legal, medical, and religious groups, offer these resources. Remember, no specific form is mandated; you can even create your own document.
- Formalize Your Directive: To ensure legal validity in Maryland, your advance directive must be signed by you in the presence of two witnesses, who must also sign. Note that your designated health care agent cannot serve as a witness. Notarization is not a legal requirement in Maryland.
- Distribution is Key: Provide copies of your completed advance directive to your physician for inclusion in your medical records. Share it with your health care agent and other trusted individuals who may need to access it when necessary. Copies hold the same legal weight as the original document.
Alt Text: Two people walking in a forest, symbolizing planning ahead for the future and making important life decisions like advance care planning.
When Does Your Advance Directive Become Effective?
Typically, your advance directive becomes active when your physician formally certifies in writing that you lack the capacity to make healthcare decisions. If your directive includes specific healthcare instructions, their implementation depends on your medical condition at the relevant time. When you appoint a health care agent, it’s essential to clearly state in your directive when you want their authority to begin – whether immediately upon incapacitation or under specific circumstances.
Alt Text: A doctor discussing healthcare options with a patient, highlighting the importance of advance directives in guiding medical decisions when a patient is unable to communicate.
Modifying or Revoking Your Advance Directive
You retain the right to modify or revoke your advance directive at any point. Any subsequent directive you create supersedes previous versions, ensuring your most current wishes are honored.
Electronic Advance Directives: A Modern Approach
While traditional paper-based advance directives are valid, electronic advance directives offer a convenient and accessible alternative. These digital forms facilitate easy creation, updates, and secure sharing of your healthcare preferences with providers anytime, anywhere. Maryland has recognized the importance of electronic advance directives and has established a program to identify services that meet stringent online security and accessibility standards. Using these recognized services allows healthcare providers to seamlessly access your electronic directive when needed. It’s important to note that you are not required to pay for your electronic advance directive to be legally recognized or utilized by healthcare professionals.
Accessing Advance Directive Forms and Further Information
Numerous organizations offer advance directive forms and resources, including medical institutions, religious groups, aging support services, and legal aid organizations. Here are a few examples:
- Maryland Office of the Attorney General: Provides resources and information on advance directives. Contact them at 410-576-7000 or 1-888-743-0023, or visit www.marylandattorneygeneral.gov/Pages/HealthPolicy/advancedirectives.aspx.
- National Hospice and Palliative Care Organization (NHPCO): Offers resources and downloadable advance directive forms. Contact them at 1-800-658-8898 or visit www.nhpco.org/patients-and-caregivers/advance-care-planning/advance-directives/downloading-your-states-advance-directive/.
- Aging with Dignity: Offers the “Five Wishes” form and resources on advance care planning. Contact them at 1-888-594-7437 or visit www.agingwithdignity.org.
For advance directive forms in languages other than English, the Montgomery County Palliative Care and End of Life Coalition provides helpful links: ADVANCE CARE PLANNING | MC PC EOL Coalition (mccelc.org).
Further information and presentations on advance care planning are available from the Office of the Attorney General.
Consider an Advance Care Card: To ensure your advance directive is readily known in case of an emergency, consider carrying a wallet card. These cards alert healthcare professionals to the existence of your directive and provide contact information for your health care agent. The Office of the Attorney General offers a free wallet card template (http://www.marylandattorneygeneral.gov/Health%20Policy%20Documents/adDir_cards.pdf), and organizations like the American Hospital Association (https://www.aha.org/system/files/2018-01/piiw-walletcard.pdf) also provide similar resources. For organizations looking to promote advance care planning and ensure individuals have easy access to these vital tools, exploring resources to create and distribute advance care cards could be a valuable initiative. While not explicitly an “Advance Care Card Affiliate Program” in the traditional sense, partnerships and collaborations focused on distributing these informational cards could significantly increase awareness and accessibility of advance directives within communities. This could be a meaningful way to support proactive healthcare planning.
