Advance medical directives are documents intended to provide guidance to medical professionals and your loved ones if you are incapacitated and cannot make your own medical decisions. The two most frequently discussed documents are a "Living Will" declaration and a Durable Power of Attorney for Health Care (sometimes offered as a combination document).

The "Living Will" Declaration is discouraged and the Durable Power of Attorney for Health Care is encouraged for the following reasons:

"Living Will" Declaration

• A vague statement generally stating that a physician may withhold or withdraw treatment if you are terminally ill or unconscious.
• A piece of paper that medical professionals may ignore or misinterpret.
• Gives blanket authority to a doctor you may or may not know, a serious concern in these days of managed care.
• Attempts to predict your preferences in often complex medical situations that you cannot foresee by offering a narrow list of options that may be used to prohibit treatment you would want in a certain circumstance.
• Allows "treatment" to be defined by state law; in many states, medically assisted nutrition and hydration is considered medical treatment.
• May be used to justify the removal of life-sustaining interventions (ventilators, feeding tubes, etc.) for patients who are disabled but not dying.
• Generally supersedes the directions of a health care agent named by the patient through a Durable Power of Attorney for Health Care.

Durable Power of Attorney for Health Care

• Names a person who will be your health care agent to make your medical decisions in any crisis, regardless of prognosis.
• Gives decision-making authority to a loved one who knows your wishes and has discussed such decisions with you.
• Legally clarifies your health care agent (as well as secondary agent if primary is unable to serve) instead of leaving such determination up to state law.
• Generally exempts doctors from liability if following directions from your health care agent.
• Defers all decisions to your health care agent.

Other Information to Consider
The first "living will" was devised in 1967 by members of the Euthanasia Society of America, now known as Choice in Dying. The Patient Self-Determination Act of 1990 requires health care facilities receiving federal funds to ask patients upon admission if they have or want to sign an advance medical directive. However, the best time to consider and sign such a document is before you are ill, injured or hospitalized.

The existence of a medical treatment or technology does not obligate you to utilize it in every circumstance. There is a "time to die" and let nature take its course when medicine and medical technology cannot reverse the dying process.

Making the Most of a Durable Power of Attorney for Health Care
A Durable Power of Attorney for Health Care document allows you to name a trusted health care agent to make decisions for your medical treatment and care if you are unable to do so. So, how does your health care agent know your wishes and preferences? For the reasons stated above, a traditional "living will" declaration is not the best vehicle for communicating with your health care agent. It is better to discuss your views with your agent outside of a formal, legal document.

How to Obtain a Durable Power of Attorney for Health Care
All states have statutes allowing advance medical directives, including a Durable Power of Attorney for Health Care (or equivalent). Copies of the document approved in your state may be obtained through an attorney, your state legislature or Probate Court. You do not have to hire an attorney in order to sign this legal document.

However, not everyone is comfortable with the standard language provided in a state statute. For individuals who want to ensure their advance directive reflects a pro-life/anti-euthanasia position, we recommend a document created by the International Task Force on Euthanasia and Assisted Suicide.

This document, titled the "Protective Medical Decisions Document" (PMDD), defines and prohibits euthanasia, as well as directs that "ordinary nursing and medical care and pain relief appropriate to your condition be provided." The PMDD is a general Durable Power of Attorney for Health Care that allows the signer to name a trusted family member or friend to make medical decisions in the event the signer is incapacitated for any reason, not just terminal illness. The PMDD may be used in any state and may be attached to the advance directive form(s) approved by your state legislature.

After signing an advance medical directive, you may want to print and laminate a brief reference to it and carry it in your wallet or billfold.

Suggested language:

I, ______________, have signed an advance medical directive. In the event of an emergency, please contact:

You can order copies of the "Protective Medical Decisions Document" from:

International Task Force on Euthanasia and Assisted Suicide
P.O. Box 760
Steubenville, OH 43952
Phone: 740-282-3810

Note: This "quick fact" information sheet is intended as general information and does not constitute legal or medical advice. For professional counsel, please contact an attorney or physician. State laws vary regarding the legality and particular details of advance medical directives.

More articles in this series

Discussing Your Medical Wishes: A Patient’s Guide
It's wise to plan ahead in case an accident or illness renders us unable to communicate our medical wishes.

Making Medical Decisions for a Loved One
What do you do if a loved one cannot make his or her own medical decisions due to an injury or terminal illness? How can you make the right choices for them?

What the Bible Says About the End of Life
"There is an appointed time for everything. And there is a time for every event under heaven—a time to give birth, and a time to die." Ecclesiastes 3:1-2. Biblical wisdom assures us that God is sovereign over life and death.

Why is there such concern about the euthanasia movement?

Related Resources

Understanding End-Of-Life Decisions I-II
Carrie Gordon Earll & Rita Marker
Broadcast CD
It's not something we like to think about, but you should ask yourself: How can I make sure my wishes about medical care are known and honored? What is a living will, and is it good to have one? What is a durable power of attorney? If you're seeking answers to questions like these, don't miss this highly informative program.

Complete Guide to Caring for Aging Loved Ones
Whether you're facing the prospect of caring for an aging loved one or are currently in the midst of it, here's the help and hope you need to manage the practical, emotional and spiritual aspects of caregiving. This long-overdue reference deals with important topics like understanding your multiple roles as caregiver, finding quality medical, financial and legal advice, and many other end-of-life issues.

Life is Sacred
DVD
This powerful, six-minute presentation will leave an indelible impression and no room to question the inestimable worth of every life—from cradle to grave.