Every year approximately three out of four deaths in the United States occur after a decision has been made to either withhold or withdraw some form of life sustaining treatment. It is further estimated that 50% of these decisions involve patients who are no longer able to participate in their health care decisions. Advance Care Planning is a decision-making process that attempts to insure that your wishes for future medical treatment are followed in the event that you cannot express your wishes. While most Americans wish to have some degree of control over their future health care choices, less than 25% of Americans have completed an Advance Directive form.  

Advance Care Planning Process

Advance Care Planning should include several steps:

• Understanding possible future health care choices
• Evaluating your options in light of your personal values
• Discussing your wishes with your loved ones and physicians
• Recording your plans in a document that is accessible in the event of a health crisis

An Advance Directive document has 2 parts:

1) A Living Will to record the type of medical treatment you may or may not want to receive. This is operative ONLY if you are unable to participate in decision making AND in a terminal or permanently unconscious state.

2) A Power of Attorney for Healthcare, also known as a surrogate decision maker or health care advocate, is the individual who will act as your decision maker in the event that you are unable to make your wishes known. It is important that this person is willing to accept this responsibility, have knowledge of your wishes and be able to advocate on your behalf.

As you begin the advance care planning process, it may be helpful to consider:

• Health care planning is best considered before a medical crisis occurs.
• Living Wills can’t address every situation that may arise but advance planning helps you maintain a degree of control in some situations.
• You can always change your mind. Your plan may change as your situation or wishes change.  Advance Care Planning is ideally done over the course of your life, not in a single conversation or with the signing of forms.
• Advance Directives don’t expire.  The forms are valid unless revoked or destroyed.
• In the state of Pennsylvania, you can prepare your own advance directive without an attorney. Two witnesses must sign the document. Your witnesses should not be related to you.
• Thinking and talking about your health care wishes can be a gift to those you love and provide you with some peace of mind, knowing that your wishes will be honored.