As people live longer, the chances of experiencing incapacity increase, and the advance health care directive becomes ever more crucial in avoiding disputes and providing a peaceful transition for end-of-life situations.

It is often asked, why do I need an Advance Health Care Directive? My family knows what I want and I trust them…

To answer that, it is helpful to distinguish between the typical scenario and the worst-case scenario. People don’t usually experience the worst-case scenario. Typically family members are united in wanting the best for the one in the hospital. Normally, doctors hardly pay attention to the health care directive. Usually, there are no disagreements.  

Usually.

But what if the worst-case scenario comes about? Are you prepared? What if there are disagreements? In that case, a health care directive can save a family. In the worst-case scenario, or even the not-worst-case, but bad-enough scenario, different family members may disagree about proper treatment. Doctors suddenly become reluctant to make decisions without clear legal authorization. Conflicting opinions about whether to continue life support may require a court order to resolve.

The Terri Schiavo case is one especially tragic example of incapacitation without advance directive for health care documents. At the age of 26, an unexpected cardio-respiratory arrest left Schiavo in a severely compromised neurological state. She had no advance care directives, and her closest relatives disagreed over her course of treatment. The initial court order to remove the patient from life support was appealed to successive Florida and Federal courts, and Congress and even the President of the United States got involved. All the while Terri lay in a coma for 15 years! 

With advance health care directives, Schiavo’s preferences would have been known, and years of discord among her closest relatives could have been avoided.

Often, young and healthy people like Schiavo have the most to gain from having advance directives. Anyone over the age of 18 may prepare advance directive documents, but adults of all ages, in all kinds of health, could likewise prevent such disputes this way.

The legal fees that result from such a conflict are astronomical and the family division is tragic. If Terri Schiavo had prepared an advance health care directive, there would have been no real dispute, little or no family division, and little or no legal fees.

What Is an Advance Health Care Directive?

An Advance Health Care Directive designates the people responsible for your health and may also state your health care wishes.

It must be a written and properly executed legal document.

The health care agent designated by the Advance Health Care Directive has the power to make health care decisions on your behalf when you are unable to do so. You can designate a single agent or co-agents. When designating a single agent, you should also name an alternate agent or two if possible.

The Advance Health Care Directive can also state your wishes for health care treatment and life support. These statements can include circumstances under which you want life support terminated, a do-not-resuscitate statement, wishes regarding living arrangements and any other wish you may have regarding your treatment when you are incapacitated.

All competent adults, regardless of their financial circumstances, should have an Advance Health Care Directive.