Free Advance Decision Template
Most people prefer not to imagine a time when they cannot personally choose medical treatments. Unfortunately, that’s a reality for many. The best time to think about your choices is now. An Advance Decision, or Advance Directive, is a document you prepare to let family members and doctors know your medical treatment preferences.
Writing down your wishes and making the document legally binding ensures that end-of-life decisions align with your desires. For instance, if you prefer that your life not be prolonged when there is no hope of improvement, you should clarify that.
Advance decisions vary by jurisdiction. In the U.S. some states require that you fill out a government-provided form. In other places, you can draft your own document. The latter provides more flexibility and allows you to clarify matters further. The template provided here allows you to tailor it to your needs.
This article teaches you how to prepare your advance medical directive. We will also discuss why it is necessary and how to ensure healthcare providers follow it.
Who Needs an Advance Decision, and Why?
Anyone who wants to choose medical treatment and procedures ahead of time can use Advance Decisions. An individual must be an adult of sound mind to sign an Advance Decision. The Patient Self Determination Act of 1990 protects Americans’ right to information about a treatment option and to refuse procedures they do not want without discrimination.
While you can make advance choices about any aspect of your healthcare, many use this document to address end-of-life situations. Advance Decisions can be amended as often as you wish, as long as you are mentally sound.
Your Advance Directive to Refuse Treatment (ADRT) can be useful in the following situations:
- You are vegetative with no hope of recovery or a better life quality. Some patients refuse treatments such as artificial ventilation, pacemakers, CPR, artificial nutrition, and hydration.
- You are in the final stages of a terminal illness: You may refuse treatments that prolong your life but offer no real relief or comfort, such as blood transfusions and dialysis.
- You have dementia or another illness that affects your brain’s functions: Some decide that if they no longer recognize family members, they would not want treatments for infections, such as antibiotics that may prolong their life but do not improve its quality.
Making decisions in advance allows you to think ahead. Contemplating your options when you are still in good health allows you to research and make informed decisions without the emotional burden of a medical crisis. Additionally, your family will appreciate not having to make the call to pull the plug on a life support machine.
An Advance Decision for healthcare is a serious decision that requires proper preparation. Before drafting and signing the document, think about what you want. The following steps outline how to create your Advance Decision.
- Think carefully about your decision: You must understand what you want and don’t want. In addition, you should consider the implications of your decision and how it may affect your loved ones.
- Talk to your doctor: Before putting your wishes in writing, consult your physician. Tell them about your thoughts and ask for their professional opinion on the consequences of your wishes.
- Write down your decision: Draft an official Advance Decision and make it legal according to your state laws.
- Inform your family and health care team.
- Keep the document accessible at all times: Some terminally ill patients wear a DNR (Do Not Resuscitate) bracelet to ensure doctors do not miss it.
If you do not make an Advance Decision, your closest family members will decide for you. Aside from feeling overwhelmed at such times, the situation can cause rifts between family members with differing opinions and deny them the chance to support each other or grieve together.
How to Write an Advance Decision?
The contents of a good Advance Decision for medical care should leave no room for misinterpretation. Include the following sections.
Personal Information
In the first paragraph, provide your name, date of birth, and address to prove your identity.
Capacity to Make the Decision
Declare that you are of legal age and sound mind. It is also necessary to express that you understand the consequences of your decision.
Specific Treatments You Refuse
List every medical procedure, treatment, and medication you do not want. Be very specific so that your doctors understand your orders.
Power of Attorney
Name your medical power of attorney and describe their role in implementing your wishes when incapacitated.
Validity
Mention how long the document remains valid and how you may revoke it if necessary.
Release of Liability for Healthcare providers
Declare that your doctors and their teams cannot be held liable for the consequences of following your wishes.
Signatures
Sign the document and print your name.
Witness Declaration
If local laws require witnesses, they should be present at the signing. They should declare that you were of sound mind when signing the document. Have them sign and fill in the date, name, and address. The witness should not be anyone who stands to benefit from your death, such as through inheritance. Consequently, people related to you by blood and marriage cannot be witnesses in your Advance Directive.
How Do I Ensure Doctors Follow My Wishes?
Some official documents may provide direction to family members and healthcare providers, but doctors may not be required to follow them. Therefore, you must check with an attorney to ensure everything is in place and that your doctors will honor your wishes.
One way to ensure doctors listen to your wishes even when you are unconscious or unable to communicate is by appointing a healthcare power of attorney. Use a Medical Power of Attorney (MPOA) to appoint someone you trust to represent you. Then, when drafting the Advance Decision, name your agent and direct that they uphold your wishes as stated in the directive.
Remember that your Advance Decision is only as good as the person you appoint to carry it out. Choose a trustworthy person who knows you, understands your personality, and knows the reasons for your choices.
Work on making the document legally binding. Depending on where you live, this may require notarizing and witnessing.
Article written by
Senior Writer | Experienced Paralegal | 79 Articles
Dena Standley is an experienced paralegal based in Houston, Texas and has over a decade of experience working as a paralegal with trial lawyers and law firms. She is passionate about making legal processes more accessible and helping people understand and navigate complex legal matters with confidence.
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