An advance directive is a written instruction, such as a Living Will or Durable Power of Attorney, for health care relating to the provision of health care when the individual is incapacitated or a notation that information about advance directives was given to the patient as required by federal law. An advance directive documents your wishes concerning medical treatments at the end of life.
Before your advance directive can guide medical decision-making, two physicians must certify the following:
•You are unable to make medical decisions.
•You are in the medical condition specified in the state's living will law (such as "terminal illness" or "permanent unconsciousness").
•You meet other requirements from the state.
A medical power of attorney (or health care proxy) allows you to appoint a person you trust as your health care agent (or surrogate decision maker), who is authorized to make medical decisions on your behalf.
Before a medical power of attorney goes into effect, a person’s physician must conclude that they are unable to make their own medical decisions. If a person regains the ability to make decisions, the agent cannot continue to act on the person's behalf.
Many states have additional requirements that apply only to decisions about life-sustaining medical treatments. For example, before your agent can refuse a life-sustaining treatment on your behalf, a second physician may have to confirm your physician’s assessment that you are incapable of making treatment decisions.
Advance directives are legally valid throughout the United States. While you do not need a lawyer to complete an advance directive, your advance directive becomes legally valid as soon as you sign them in front of the required witnesses. The laws governing advance directives vary from state to state, so it is important to complete and sign advance directives that comply with your state's law. Also, advance directives can have different titles in different states.
Emergency medical technicians cannot honor living wills or medical powers of attorney. Once emergency personnel have been called, they must do what is necessary to stabilize a person for transfer to a hospital, both from accident sites and from a home or other facility. After a physician fully evaluates the person's condition and determines the underlying conditions, advance directives can be implemented.
Some states do honor advance directives from another state. Others honor out-of-state advance directives as long as they are similar to the state's own law. Some states do not have an answer to this question. The best solution is to complete the advance directives for all the states in which you spend a significant amount of time.
Advance directives do not expire. An advance directive remains in effect until you change it. If you complete a new advance directive, it invalidates the previous one.
You should review your advance directives periodically to ensure that they still reflect your wishes. If you want to change anything in an advance directive after you have completed it, you should complete an entire new document.