 Your physicians will give you information and advice about treatment. You have the

right to choose. You can say “Yes” to treatments you want. You can say “No” to any

treatment you don’t want.

How Do I Know What I Want?

 Your physician must tell you about your medical condition and about what different

treatments can do for you. Many treatments have “side effects”. Your physician must

offer you information about serious problems that medical treatment is likely to cause

you.

 Often, more than one treatment might help you – and people have different ideas about

which is best. Your physician can tell you which treatments are available to you, but

your physician can’t choose for you. That choice depends on what is important to you.

What If I’m Too Sick to Decide?

 If you can’t make treatment decisions, your physician will ask your closest available

relative or friend to help decide what is best for you. Most of the time that works. But

sometimes everyone doesn’t agree about what to do. That is why it is helpful if you say

in advance what you want to happen, if you can’t speak for yourself. There are several

kinds of “advance directives” that you can use to say WHAT you want and WHO you

want to speak for you.

What is an Advance Directive?

 An advance directive is a written or verbal statement that is made and witnessed in

advance of serious illness or injury about how you want medical decisions made.

 Two (2) forms of advance directives are:

o Living Will, and

o Healthcare Surrogate Designation.

 An advance directive allows you to state your choices about healthcare or to name

someone to make these choices for you if you become unable to make decisions about

your future medical treatment.

What is a Living Will?

 A living will generally states the type of medical care you would or would not want if

you become unable to make your own decisions. It is called a living will because it takes

effect while you are still living.

What is a Healthcare Surrogate/Durable Power of Attorney Designation?

 A Healthcare Surrogate/Durable Power Of Attorney Designation is a signed, dated and

witnessed document naming an adult relative or friend as your agent to make medical

decisions for you if you should become unable to make them for yourself. Sometimes

treatment decisions are hard to make and it truly helps your family and your physicians if

they know what you want. The DURABLE POWER OF ATTORNEY FOR

HEALTHCARE also gives them legal protection when they follow your wishes.

Who Can Fill Out These Forms?

 Anyone 18 years or older can fill out Advance Directive and/or Healthcare Surrogate

Designation forms. You don’t need a lawyer to fill it out.

What Should I Do With My Advance Directive If I Choose to Have One?

 If you have designated a Healthcare Surrogate/Durable Power of Attorney for Healthcare,

give a copy or the original to that person.

 Give a copy of your advance directive to your physician for your medical file.

 Keep a copy of your advance directive in a safe place.

 Keep a card or note in your wallet or pocketbook that states you have an advance

directive along with the names and telephone numbers of your healthcare surrogate and

physician.

 If you change your advance directive, be sure your physician/lawyer and/or family

member has the latest copy.

What If I Change My Mind?

 You can change or revoke any of these documents at any time, as long as you can

communicate your wishes verbally or in writing.

Do I Have to Fill Out One of These Forms?

 No, you don’t have to fill out any of these forms if you don’t want to. You can just talk

with your physicians and ask them to write down what you’ve said in your medical chart.

And you can talk with your family. But people will be clearer about your treatment

wishes if you write them down. And your wishes are more likely to be followed if you

write them down.

Will I Still Be Treated If I Don’t Fill Out These Forms?

 Absolutely. You will still get medical treatment. We just want you to know that, if you

become too sick to make decisions, someone else will have to make them for you.

How Can I Get More Information About Advance Directives?

 Ask your physicians, attorney or local hospital for more information.