What is an Advance Directive?

An advance directive is a document that you complete to let people know what your wishes are should something happen to you and you are not able to communicate your wishes. There are 3 basic advance directives: A Health Care Proxy, a Living Will and a Do Not Resuscitate (DNR) order.

My recommendation is that you complete a Health Care Proxy and be sure to tell that person what your wishes are. This should be a dynamic conversation that is on-going and can be revised as people age or  suffer from various illnesses. Download a pdf Health Care Proxy Form here.

A Living Will is a document that specifies what you want done or not done when something specific happens to you. The problem with a Living Will is that it may not cover what actually ends up happening to you.

A Do Not Resuscitate Order (DNR) is signed by a doctor with the consent of the patient. If the patient is unable to communicate, a loved one or good friend can make the decision for them. A DNR Order does not mean that you are forgotten about, nor does it mean that you will not receive pain medications. Nutrition, bathing, etc. continue as normal. If your heart stops beating or you stop breathing, the hospital will not call a "code" on you. When a code is called, you receive cardio-pulmonary resuscitation, drugs and chest compressions and in most cases, intubation ( when a tube is put down your throat to enable to you to breathe).  

A Brief History of Health Care Proxies

In the 1970's there was a young woman named Karen Ann Quinlin who stopped breathing for two 15 minute periods of time. She was left in a persistent vegetative state, being kept "alive" by a respirator and by being fed through a tube (artificial nutrition/hydration). After about 10 years, her parents asked the nursing home to remove Karen from life support. The nursing home refused and so the parents went to court to have the nursing home ordered to remove the artificial respirator. The court agreed. Karen was removed from the respirator, but not from the feeding tube. She lived another 10 years before succombing to an infection.

In the mid-80's a young woman named Nancy Cruzan was in a terrible car crash that left her in a persistent vegetative state. After several years, her parents went to court to ask that life support be removed.  The cout decided that people had a right to self-determination, but they had to tell someone what thier wishes were. The case was sent back to the lower court whcih found that there was clear and convincing evidence that Nanacy would not want to be kept alive by artificial means. The respirator and feeding tube were removed and she died.

In response to these situations, the government decided to create the Patient Self-Determination Act. Each state then had to decide how it wanted to comply with that act. New York State chose The Health Care Proxy Law. Please see the "New York State Laws" section for more detailed information.

 You can download a pdf of a proxy form here.