Consider this scenario. You are in a hospital with a terminal illness, unconscious, connected to all kinds of medical machines, and has a very poor prognosis. Who will speak on your behalf during this time of illness? Who would tell the doctors, the nurses and your family members what your medical wishes are if ever you get into this terminal condition? Who would let your caregivers know what you would like to happen to you and your body in such a condition like this? Would you like to be kept alive by all means? Or would you rather decide not to be subjected to futile treatments knowing that this is not a dignified living for you? But how would you let everyone know all these wishes now that you are no longer capable of speaking up for yourself?
This is why Advance Health Care Directives (AHCD) are very important. As a clinical counselor working in a hospital for several years now, I have personally worked with families and witnessed them break apart because they could not agree in making medical and end-of-life decisions for the dying loved ones. Their loved ones, who were unable to speak up for themselves, did not have an advance directive. Remember the Terry Schiavo case?
I have witnessed many cases where, because patients did not have an AHCD, families and caregivers are plagued with guilt and have constantly asked themselves if they were making the "right" decision for their loved one or for themselves. Yet, I have also witnessed many cases where, because patients had an AHCD, their families and caregivers felt at peace, in spite of the pain, just because they knew they were honoring their loved one's medical wishes as reflected on their AHCD.
WHAT ARE ADVANCE HEALTH CARE DIRECTIVES (AHCD)?
AHCD are legal documents that enable you to do the following:
1. Appoint or designate a primary and secondary power of attorneys for health care whom you trust to speak on your behalf and honor your medical wishes in an event that you could no longer speak up for yourself.
2. Appoint a primary physician whom you trust to be your doctor or caregiver.
3. Make your end-of-life wishes known.
4. Make your wishes known regarding organ donation.
5. Make your wishes known regarding pain control.
For an AHCD to be legal, it has to be signed by you (the person creating the document) before two witnesses. These witnesses could not be your designated power of attorneys or your immediate family members or your health caregivers where you receive medical care. Close friends or distant relatives could be witnesses. If you cannot find witnesses, the document could be notarized by a notary. The notary can only notarize an advance directive if you have a valid photo ID (e.g. driver license or passport). This process applies particularly in California. Other states may have different processes.
I would also like to mention that a Living Will is a kind of AHCD. Likewise, an AHCD could also be known as "Durable Power of Attorney for Health Care."
WHAT DO YOU DO WITH YOUR ADVANCE HEALTH CARE DIRECTIVE?
Once you created your AHCD, you keep the original and remember to keep it in an accessible place in your home. If possible, make several copies to give to your designated power of attorneys, your primary physician and to your hospital. I strongly encourage people to always bring a copy with them whenever they go to the hospital so that the hospital will not only have a copy of your document but also will know and honor your medical wishes. While creating an AHCD is not mandatory, it is a Federal Law that hospitals have to ask patients during their admission if they have an AHCD.
WHERE CAN YOU GET ADVANCE HEALTH CARE DIRECTIVE FORMS?
Most, if not all, hospitals have AHCD forms. You can always ask your hospital if they have available forms. You can also ask your doctor if he/she has a form. There are many websites now on the Internet that offer AHCD forms. Just do a search on "Advance Health Care Directives."
I believe that your completed (properly witnessed or notarized and signed) AHCD is legally recognized in states other then your own. However, since each state may have its own froms and probably laws on AHCD, the best thing to do is to always bring an extra copy with you when traveling.
WHO CAN FILL OUT AN AHCD?
Many folks think that an Advance Health Care Directive is only for patients who are terminally ill. Not so. Any competent adult, 18 years old and above, can fill out an AHCD. I remember dealing with the family of a 20 year old woman who ended up on a persistent vegetative state (PVS) as a result of a car accident. Her parents ended up divorcing just because they could not agree as to what to do with her in her grave condition. The mother believed that her daughter loved life so much that she would not like to be living in such a terrible medical condition where there is no dignity of life any longer. The father thought otherwise. This sad break-up of a family would have not happened if, even at early age, their daughter had an advance heatlh care directive.
I strongly encourage you to talk to your physician or family members about this difficult yet very important subject. I just hope that this article has been a source of help.
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