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What Is an Advanced Medical Directive?

An advanced medical directive—sometimes called a living will, advanced directive, personal directive, or advance decision in some jurisdictions—is a tool or vehicle for communicating an individual's preferences pertaining to his or her health and wellbeing in the event that the individual is unable to make those decisions because of an illness or other incapacity. The directive serves to appoint a replacement person to become the decision-maker on behalf of the infirm or incapacitated individual.

Why Were Advance Directives Created?

Advance directives, as a health care planning tool, were created in reaction to the complexity, sophistication, and wide-spread impact of technological advances in the medical field. In the United States, many patients die in the care and custody of health care facilities. In some instances, end-of-life care is more costly, painful, prolonged, or burdensome than necessary on the patients themselves, as well as on their family members.

Many individuals today reside in nursing homes and are only surviving with the nourishment provided through feeding tubes. Some of those nursing home patients are living in comatose states and are considered to be in vegetative conditions. The costs of such care are staggering. Patients and/or their family members are flying through their savings despite having insurance, some are losing their primary income sources, and others are having to quit their jobs to care for ailing family members.

However, most people, when asked, agree that they would prefer not to have major medical treatment or aggressive care to prolong their lives if they are incapacitated, incompetent, or in some other type of severely diminished state of prognosis. With increasing numbers of citizens suffering from the burdens of costly and aggressive medical care with lessening benefits and diminishing prognoses, our society has created ways to try to avoid the unnecessary pain and suffering, as well as the tremendous cost burden. The pressures on law and policymakers are mounting in cases where invasive medical treatments are performed on those who do not seek or prefer such treatment due to the poor prognosis of the state of their health. The living will is a vehicle that was created in response to this specific dilemma.

What Is the Relationship of a Living Will to an Advanced Medical Directive?

A living will is a specific and particular type of advanced directive. A living will serves to give instructions to third parties for an individual's medical treatment.

What Are Powers of Attorney or Health Care Proxies?

Other types of advanced directives concern special forms of powers of attorney or health care proxies. In these instances, a party is appointed by an individual to make decisions on that individual's behalf when he or she is incapacitated and cannot make the decisions on his or her own.

Combination Planning Tools Provide the Most Comprehensive Care

It is possible to have a combination of both types of tools in a single document. Many attorneys and financial planners strongly advise their clients to create both a living will and a health care proxy. By having the combination of tools, clients are able to provide the most comprehensive planning for their future health, financial, and overall care.