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What’s Important About an Advance Directive?

By Mary McDonald Aquino, Esquire

What is an advance directive? Do I need to have one?  An advance directive allows you to make certain decisions about your health care particularly in situations when you may no longer be able to make decisions yourself. For, example, would you want a feeding tube or breathing machine if you had a terminal condition?

A Maryland law called the Health Care Decisions Acts tells you how you can make a legally valid advance directive. An advance directive can be written or oral and the Health Care Decisions Act sets out two optional forms you can use to write an advance directive. So you do not need a lawyer to prepare these documents for you. However, if you do not understand the forms or you have questions, you might want to consult with an attorney. You can also discuss any medical questions with your doctor.

What are the two forms and how do you prepare them? The shorter of the two forms is called a “Living Will” which lets you decide whether you want life sustaining treatment in the event of a terminal condition of persistent vegetative state. You need to witnesses to be present when you sign this form and the witnesses must sign and give their addresses. A witness can be any competent person and at least one witness cannot knowingly benefit financially from your death or be entitled to any part of your estate.

The longer form is called “ Advance Directive” and it has two parts, Part A and Part B.

Under Part A you can appoint a health care agent who will have the authority to speak for you and make decisions regarding your health care based on what you want done or your best interests. You can name anyone who is 18 years of age or older except an owner, operator, or employee of a health care facility where you are receiving care. You can also choose a back-up agent in case the first agent is unavailable. Many people choose family members. Whoever you pick, make sure you discuss it with them first to make sure they are willing to accept the responsibility.

The Part B form lets you decide about life-sustaining treatment in three situations: terminal condition, persistent vegetative state and end stage condition such as advanced Alzheimer’s disease. You can also use this form to make health care decisions that do not involve life-sustaining procedures. If you complete the Part B form, you do not need to fill out the Living Will form. The witnessing requirements are the same for Part B forms as for the Living Will except the health care agent can’t be a witness.

Where can you get these forms? The Maryland Attorney General’s office, in addition to hospitals and health care providers, has these forms. The Attorney General’s office includes a guide with its forms and they can be obtained by calling (410) 576-7000, or by writing to Attorney General’s Office, 200 St. Paul Place, Baltimore, Maryland 21202.

Who should have copies of your advance directive? Give copies to your doctor(s), your health care agent (if you name one), family members or friends who should know of your wishes and any hospital or nursing home in which you are a patient.

How do you make an oral directive? You must make the health care instruction in the presence of your doctor and at least one witness, it must be written in your medical records and dated and signed by the doctor and witness.

Knowing what health care decisions you would want made if you had a life threatening illness is not always easy. Discussing with family members, friends or your doctor what you would want done and preparing a living will or advance directive can help to ease some of the burden. Advance directives can be changed or revoked at any time. You should review what you want occasionally since your attitudes or beliefs can change over time.

Revised June 13, 2012

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