What are Advance Directives?

Printer-friendly versionPrinter-friendly version
What are advance directives?
During a serious illness you may be unconscious or unable to communicate your wishes regarding medical treatment. An advance directive allows you to record your wishes regarding medical treatment. It is signed in "advance" to let your doctor and other health care providers know your wishes concerning medical treatment.

What kinds of advance directives are there?

There are four basic types of advance directives:
  1. Medical Power of Attorney - authorizes someone to make medical decisions on your behalf if you become incompetent. A Medical Power of Attorney can be a separate document or can be part of a Durable Power of Attorney. Other powers can be included in the Durable Power of Attorney authorizing someone to act on you behalf.
  2. Living Will - states your wishes about the use of artificial life support to keep you alive if you are terminally ill or permanently unconscious. It also may include your wish to donate organs and tissues after your death.
  3. Health Care Surrogate - you designate a person who will make health care decisions for you if you are unable to do so. This designation can be in a Power of Attorney, a Medical Power of Attorney, Living Will, and/or DNR Order.
  4. DNR (Do Not Resuscitate) Order - directs that in the event of your cadiac or respiratory arrest that your wishes in the DNR Order be honored. DNR means that if your heart stops beating or if you stop breathing, no medical procedure to restart breathing or heart function will be started by emergency medical services personnel.
Why should I have an advance directive?
If you have an advance directive, you increase your control over your medical treatment in the future. It also helps to ensure your right to accept or refuse medical care. If you have an advance directive, it may help your family make decisions in the future because your family will know what you want and who you want to make decisions for you if you are unable to make the decisions yourself.

What happens if I don’t have an advance directive and I become unable to make my own medical decisions?

If you do not have an advance directive and you become unable to make your own decisions, the medical staff can go to family members to see what to do. If family members disagree about your medical care, someone may need to go to court and get a guardianship over you in order to make the necessary medical decisions.

What happens if I don’t have a living will?

If you do not have a living will and are terminally ill or permanently unconscious, by Kentucky law, the medical staff must ask the following persons, in this order, to make decisions about artificial life supports, including artificially provided nutrition and hydration:
  • Your guardian, if a court has appointed one
  • Your spouse
  • Your adult child, or if you have more than one, a majority of your adult children who are reasonably available for consultation
  • Your parents or
  • Your nearest living relative, or if you have more than one relative of the same relation, a majority of those who are reasonably available for consultation.

My father is in the hospital in a coma and can’t make decisions. Can we get an advance directive or living will for him?
No. An advance directive or living will must be done by the person who will need the medical care, and it must be done while the person is competent to make such decisions.



Reviewed August 2009