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Advance Directives

It's a mistake to think that healthy people don't need advance directives. Illness or injury can incapacitate a person at any age. Three of the highest profile cases resulting in protracted litigation over medical treatment involved Nancy Cruzan, age 25 at the time of her car accident; Terri Schiavo, age 26 at the time of her heart attack; and Karen Ann Quinlan, age 21 at the time she fell into a coma after mixing alcohol and drugs.

So, when is the right time to let your family know how to best advocate for you in the event that you are medically unable to do so yourself? There is only one answer, and it applies to all of us: the right time is now.

If you are currently healthy, this is the ideal time to begin the process:
  • Start by reaching out to family members and/or friends. Let them know that you would like to discuss your advance directive.

  • Reassure them that you are healthy and that you view this as an important responsibility for any adult.

  • Let them know why you have made certain choices, such as when a DNR should be implemented. See also: What decisions do I have to make for my advance directive?

  • Give them a chance to ask questions. Consider any objections seriously. Respond respectfully to their concerns.

  • Remember that the choice is yours and your decision must be accepted.

  • Use this time to choose a health care representative. Ideally, this will be a family member or close friend who is willing and able to advocate for your preferences as shown in your advance directive. See also: How to choose a health care representative.

  • Give copies of the advance directive to your representative, your doctor, your lawyer, and anyone else applicable.  Keep a copy with your important papers.

  • When done, cross it off your to-do list and get back to your everyday concerns.

If you are seriously ill, you have no option to wait. The time for discussion is right now.

You are potentially facing many important medical decisions. It is imperative that you give serious thought to how aggressive you want to be in terms of treatment. Your doctors and friends need to know what you want so they can honor your choices. Failure to act now may leave your family in the terrible dilemma of trying to guess your wishes if you become incapacitated. Lack of clear direction may also lead to bitter family fights and drawn-out legal procedures as the courts struggle to determine what your wishes would be.

Holding a discussion:

  • Call your family together.

  • Let them know about the medical situation you are facing and what your wishes are.

  • Your loved ones may try to reassure you that "there's plenty of time for that kind of talk" and you "need to think positively." Do not allow their fear and denial to stop the conversation, even though they are coming from a place of love and concern. Make it clear that this discussion is important to your peace of mind.

  • Go over your preferences and your reasoning. Allow thoughtful pushback. Consider these responses carefully.

  • Ultimately, this is your life and your choice. Make your final decisions clear.

  • Provide and distribute copies of your advance directive.

  • Ensure that all family members know who your designated health care representative is.

  • Close by telling your family and friends, “Many of you have asked how to help me at this very difficult time. One of the most important things you can do is honor my wishes."

  • Ask each family member to respect your choices and to not litigate or otherwise challenge your decisions or your representative.

If you want to read more about what factors to consider when creating your advance directive:

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