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Completing Your Document

An advance healthcare directive allows its maker, called the "Principal," to specify his or her healthcare preferences in the event he or she becomes incapacitated or unable to speak. This helps the principal and his or her family to rest easy knowing that the principal's wishes will be honored. Each advance healthcare directive also includes a Durable Power of Attorney for Health Care section, which names a healthcare agent (also called a proxy) who can make decisions for the principal in the event he or she lacks capacity. The agent is required to follow the directions stated in the advance healthcare directive and to act in the principal's best interest in situations in which the principal's wishes are not specified. For this reason, it is important for the principal to discuss his or her wishes with the agent so that the agent can act accordingly should the situation arise. It is a good idea for the principal to name a trusted friend or family member as the agent.

It is important to note that the principal will initial next to all of his or her main preferences concerning health care once the document is printed out. Therefore, most of the questions you will answer on LegalNature's online form builder will be related to optional matters used for customizing your document according to the principal's preferences.

Special Directions (Optional)

After entering the principal's basic information, you will have the option to specify what the principal wants or does not want to occur when he or she becomes terminally ill, injured, or permanently unconscious. For instance, the principal may specify any specific pain relief measures that are wanted or not wanted. Also, describe any chronic illness or serious disability that the principal may have that he or she does not want to be misinterpreted as a terminal condition. Again, this section is optional, so if the principal has no specific directions then you can skip to the next step.

Guardian Nomination (Optional)

On this step you have the option of nominating a guardian to manage the principal's personal affairs in the event he or she becomes incapacitated. This person will make decisions such as where the principal lives or what the principal eats. If the principal doesn't nominate a guardian, a court may appoint one when the time comes.

Designation of Primary Physician (Optional)

Here you can designate the primary physician in charge of the principal's health care. It is a good idea for the principal to review the advance healthcare directive with the physician so that the physician understands the principal's healthcare preferences and the principal understands his or her choices.

Organ Donation and Autopsy (Optional)

Including this section will allow the principal to specify whether or not he or she wants to be an organ donor and whether an autopsy will be performed upon death. If the principal has not specified these preferences yet in a formal document, it is probably a good idea to do so here.

Mental Health (Optional)

On this step you will have the option to include the principal's wishes concerning mental health treatments, including whether or not the principal consents to receiving psychotropic medications. These are medications such as antipsychotics or antidepressants. List any medications the principal does or does not wish to receive and any other preferences concerning mental health treatments. 

Funeral and Burial (Optional)

The funeral and burial section allows the principal to indicate the manner in which his or her remains will be disposed of and the location of any funeral. You can customize this section any way you need to.

Witnessing Your Document

After completing your document, you will need to print it out and read the witnessing instructions included in it. Each state has slightly different requirements on how an advance healthcare directive must be witnessed and executed. Any witnesses, including any notary, will need to physically see the principal sign the document. Be sure to read the document carefully and have all the required persons sign. Also, your document will tell you if you need to have your signature notarized. If it says that a notary is optional, then you do not have to use a notary, but using one will help prove the document is valid if it is ever contested in court.

Registering Your Advance Healthcare Directive

Many states maintain a registry for the advance healthcare directives of their citizens. Registering the advance healthcare directive can help the healthcare provider and principal's family to be able to locate a copy of it in the event they cannot find the original. If you are interested in registering, check online to see if your state maintains one and follow the directions for filing.

Changing Your Document

If the principal decides that he or she wants to change or revoke the advance healthcare directive and/or durable power of attorney for health care, the principal can do so at any time while he or she still has the mental capacity to do so.


Ready To Get Started? Create an Advance Healthcare Directive

Frequently Asked Questions

What is an advance healthcare directive?

An advance healthcare directive is also called a living will. This important document allows you to specify your wishes about medical treatment at the end of your life or in the event you are unable to make decisions.

Advance healthcare directives are commonly used in the following scenarios:

  • Terminal illness
  • Permanent coma
  • Persistent vegetative state
  • Traumatic brain injury
  • Dementia or Alzheimer’s disease
  • Other medical illnesses which impact mental capacity

Before the directive becomes effective for decision-making, your physicians must agree that you are unable to make decisions about your medical care. You also need to be in the medical condition that your state’s law requires, usually either with a terminal illness or in a permanent state of unconsciousness. Once these requirements are met, the healthcare providers working on your care will tailor your treatment to match your wishes stated in the document.

Advance healthcare directives are legal throughout the U.S. and you do not need a lawyer to create one. Your advance healthcare directive becomes legal as soon as you sign it (with the required witnesses).

When should I use an advance healthcare directive?

If you are concerned about what would happen to you or how you would be treated in the event of a medical crisis, injury, or illness that left you unable to make decisions, an advance healthcare directive can put your mind at ease. This practical document can ensure that your wishes are understood and followed and even makes things easier for your family if they are struggling with difficult decisions about your care. Setting up an advance directive while you are healthy and competent ensures that the document will be valid and that your loved ones understand your wishes.

Your advance healthcare directive can include your preferences about any or all of the following aspects of care:

  • Resuscitation, including if you want CPR or electric shock stimulation
  • Ventilation by mechanical device
  • Tube feeding via IV or stomach tube
  • Dialysis to remove waste from your system if your kidneys are not working
  • Administration of antibiotics, antivirals, and other medications
  • Palliative care, comfort care, and pain management including hospice care
  • Tissue and organ donation wishes

Considering all of these factors ahead of time and incorporating the things that are important to you in your directive can give you peace of mind and ensure that your family members understand your wishes.

What is included in an advance healthcare directive?

In general, an advance healthcare directive contains the following sections and information:

  • A declaration section which states that you are in your right mind and aware of your options. This section expresses your legal right to make decisions about your care.
  • The condition you must be in before you may be considered unable to make decisions and your wishes regarding the treatment of ongoing illnesses. If you are in a coma, not mentally competent, unconscious, or in another state, you can detail when the advance directive should be enforced.
  • Your actual wishes and directions for care. This section could be long or short depending on your individual preferences. It includes directions for your doctor on what to do if you need to be resuscitated, what to do about palliative care or pain relief, and what specific actions or treatments you do not want, including ventilation, tube feeding, and resuscitation.
  • The treatments you want to have if you are incapacitated and unable to express your wishes, detailed specifically so that your treatment team and family knows what to do.
  • Your signature and the signature of your witnesses will need to be included.

The more specific you are in your advance directive and the more circumstances you outline, the easier the document will be for your healthcare providers and family to follow. You may also choose to appoint a healthcare agent (also called a proxy) in addition to creating your advance healthcare directive. This person is entrusted with making healthcare decisions for you if you are incapable of doing so for yourself and in case the circumstances in question are not covered in your advance directive.

What do I need to know to prepare my advance healthcare directive?

You do not need an attorney to create your advance healthcare directive.

If you receive a different or new diagnosis or anything changes in your health or prognosis, then you should revisit your advance healthcare directive and amend it as needed. You will need to create new forms and redistribute and replace them with all parties involved.

Can my healthcare professionals refuse to follow my advance directive?

Your advance directive should outline your wishes, but your doctors are not obligated to follow it. If your doctor has a conscientious objection to one or more of your instructions, he or she is not required to follow it. However, the doctor should transfer you to another provider who will comply.

The best way to ensure compliance with your wishes is to speak to your doctor and healthcare team ahead of time and make sure they understand your advance directive and agree to follow it. Your family and healthcare agent can also help ensure your wishes are followed, provided you supply them with the most up-to-date copy of your advance directive and talk to them about your specific wishes in advance.

Is a lawyer needed to complete an advance healthcare directive?

No, a lawyer is not required for this document. While you do not need an attorney, you should make sure you understand all of the provisions and the consequences involved. Your physician can help explain your options.

Although an attorney is not required, you will need to read the document carefully and sign it. One or more witnesses and a notary may be required to witness you sign the document depending on your state.

Ready To Get Started? Create an Advance Healthcare Directive