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Advance Directive (Living Will) and Durable Power of Attorney for Healthcare (Medical Proxy)
Questions to Ask Yourself
I. Thinking about Your Health Care Wishes
Why am I writing an advance directive?
What are my treatment wishes?
In situations near the end of life?
In situations of serious injury or illness?
II. Talking with Others
Physicians and other health care professionals
Do I understand the medical terminology?
Do they understand my wishes?
My friends, family and others
Have I directly and thoroughly discussed my wishes with them?
Do they understand my wishes?
III. Selecting a Health Care Representative
Am I confident that my designated representative understands my personal values and health care wishes?
Does my health care representative understand his or her responsibilities?
Has he or she clearly agreed to serve as my representative and to communicate my wishes to my doctor and others concerned with my care?
Have I selected an alternative health care representative?
IV. My Instructions. Have I clearly stated my instructions and included other relevant information about my treatment wishes regarding:
the provision, withholding or withdrawal of specific treatments?
artificially provided fluids and nutrition?
the medical conditions in which I want my wishes implemented?
special considerations I may have concerning my care and treatment?
V. Witnesses. Have I had my directive properly witnessed?
VI. Distribution of My Advance Directive. Have I given a copy of my directive to those who should have one, such as:
my health care representative?
my physician or other health care provider?
the hospital or nursing home, which I am about to enter?
family members, friends, alternate representatives and my religious advisor?
VII. Periodic Review. Have I made a note to review my directive on a regular basis in the future?
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