Why Do I Need an Advance Healthcare Directive?

The Advance Health Directive* document serves two principal functions. It appoints an individual to act as your Health Care Agent and make decisions about your medical treatment when you cannot speak for yourself. It also guides your healthcare agent and medical professionals to make those treatment decisions in accordance with the wishes you describe on the form. For example, it may be used to record additional wishes -- details for your memorial service or organ donation. The Health Care Agent is the surrogate decision maker or healthcare power of attorney.

In the absence of a Directive, physicians will act under current law and norms of the medical profession, to pursue all means necessary to prolong your life. A physician may consult with the family to determine your wishes. However, this is usually a challenging and emotional time for the family, and family members frequently disagree over what they think you would want and what decisions to take. The Advance Directive is a gift to both your family and yourself. It removes the burden and guilt of making the tough choices from your family's shoulders since the Agent is implementing your specific, written instructions.

Before you fill out an Advance Directive, it is essential to understand your own values and wishes. Under what circumstances do you want to remain alive? For instance, how important is the ability to communicate with those around you? There is no right or wrong answer; these are intimate and individual decisions that each of us needs to make for ourselves. Once we have clarified these values in our own minds, we can address any medical treatment as options to enable or maintain a desired quality of life: "I want this treatment if it will enable my wishes," or, "do not take measures to extend my life, if they have no power to cure my illness and may restrict the quality of my life."

Every adult should have an advance directive. It is also essential to share the form with your healthcare agent, family, and doctor. Advance Care Planning is a process not a one-time event. Circumstances change; what's important to us changes. Revisit the Directive every five years and after significant life events. Revise it if needed. Several forms exist; most states and health-care providers offer one. Pick one that you like best.

Need more guidance? Contact us at HCI, we can help!

*This article is specific to the United States. Please consult local guidelines in other countries.

Mukund Acharya

Resident Faculty, CHT Program; Director, Ananda Corps; Member, Board of Directors, HCI

Mukund Acharya is Resident Faculty for the CHT Program, Director of Ananda Corps and Member of the Board of Directors at HCI. He is also President and a co-founder of Sukham.