I’m 47 years old, I am healthy and I live an active and fulfilling life. I recently learned about a document called an Advance Health Care Directive. Can you explain what that is and if I should have one? Andy from New York City
Those are two good questions, Andy.
First, an Advance Health Directive, often called a Living Will, is, most importantly, a legal Power of Attorney specifically and only for medical decisions. You give someone the legal authority to make medical decisions about your health care when you are no longer able to make those decisions for yourself. For example, if you cannot speak, you’re in a coma or unconscious state, or you’re mentally incapable of making good choices.
Secondly, the Advance Health Directive provides some examples and choices to which you can record on the Directive, the particular choices you would want your legal Power of Attorney to make, if need be. Do you want CPR (cardio pulmonary resuscitation) if your heart stops? What decisions would you want made if you’ve experienced brain damage, in a coma and/or are hooked up to machines keeping you alive? How much pain medication would you want? Do you want doctors to take all possible measures to keep you alive? Each State has a generic Advance Health Directive available, and often times, when you go into a hospital, they will provide one if you don’t have one. The Advance Health Directive called The Five Wishes is the best version I’ve seen. It’s available online at
When you’ve filled it out, have your original copy notarized or witnessed by two people.
Give a copy of your Directive to your legal Power of Attorney listed in the Directive, one to the alternate person listed, one to your Primary Care Physician, one to each of your children, wife, next of kin, and one to your lawyer. Keep your Directive where you, or someone, can easily find it. I suggest that the primary or alternate person be someone who won’t need a plane ride to get where you are.
And thirdly, the value of having a written Advance Health Care Directive is that it will help you clarify your thoughts and feelings about your preferences for healthcare in certain situations. It will help you start, or continue the conversation with your family, doctor, etc., and most importantly with the person(s) you are assigning (with their permission) to be your legal Power of Attorney for medical decisions. If you have children, it’s important they all be on the same page with you.
Sometimes it’s a great way to initiate a conversation with your aging parents. “ …..Mom, Dad, I just filled out my Advance Directive, do you have one……?”
I have been in hospitals at the bedside, where having an Advance Health Directive made a real difference in the procedures and outcome of patients, and too, I have seen the confusion and misunderstandings when there wasn’t one, and, for example, the grown children of a patient had different views on treatments, or felt a tremendous burden they’ve been unintentionally handed to make, what could be, a life and death decision.
It’s important to know that the decisions you spell out in your Advance health Care Directive are not cemented in stone or legally binding, which means sometimes, even though Grandma said this, she might not want this, given the conditions of the moment. So then it still falls on the legal Power of Attorney to consider what would grandma want done given these circumstances, and of course, sometimes that decision is whether to ‘pull the plug’ to end grandma’s life….
One of my teachers refers to the Advance Health Care Directive as ‘”Writing a postcard about a place we’ve never been”.
Your second question, “Should I have one?” is also a great question. Often times, people assume that Advance Health Directives are for old people. Of course, old people aren’t the only people dying. We sometimes forget that. So then, should you have one? I don’t see any downside to you filling out an Advance Health Directive. You can always make changes to it as you have a change of mind. And again, it’s a great conversation bridge starter with your parents and friends. Then again, you probably have plenty of time………….
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Reverend Bodhi Be is an interfaith minister ordained in a universal Sufi lineage. He is the Executive Director of Doorway Into Light, an educational and charitable organization on Maui providing conscious and compassionate responses to dying and death since 2006, and offering community workshops and presentations. Doorway Into Light operates Hawaii’s only nonprofit funeral home and only certified green funeral home.
Bodhi is an independent funeral director; end-of-life and bereavement counselor; hospice volunteer; a teacher and trainer of death midwifery; a speaker and workshop leader in the fields of wholehearted and sacred living and dying, and a ceremonial guide. Bodhi facilitates grief groups in schools for children, teenagers, and adults.
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