By Martha A. Simpson, D.O., M.B.A.
Associate Professor of Family Medicine
Ohio University College of Osteopathic Medicine

TO PREVENT A “FAMILY FEUD” ALL ADULTS NEED AN ADVANCE DIRECTIVE

Question: Recently I had a minor procedure at the hospital. When I checked in they asked me if I had advance directives. I don’t. I thought they were for the elderly. I am only 22. Can you tell me more about them? Should I have one?

Answer: Many people feel that they are too young to think about dying or making their last wishes known, but it is never too soon to prepare documents that can communicate your wishes if you are unable to. There are several different types of documents that fall under the broad category of advance directives that you mentioned in your question. The laws surrounding these kinds of legal documents vary from state to state, but I will try to give you some useful definitions and general information.

An advance directive instructs health-care personnel about how you would like to be cared for if you become unable to make medical decisions yourself. Depending on the type of document, you might name a person to make your health-care decisions or give your own explicit instructions.

Usually, when a person is in a coma or otherwise unable to make his or her own medical decisions, the law allows the closest relative to make these decisions. As long as there is no disagreement between the physicians and the various family members, things usually proceed smoothly. However, when there is disagreement about what care should or shouldn’t be rendered, these decisions can become contentious. In that event, the decision could be made by a court or a court-appointed advocate. While courts and court advocates act responsibly, they may not act as you would have wished them to.

There are two different types of advance directives that can help prevent this type of family feud scenario. First, there is a durable power of attorney (DPA) for health care. Second, there’s a document called a living will. Let’s take a brief look at each.

Most states recognize the DPA for health care. This document allows you go choose a person you trust to legally make medical decisions on your behalf. To get the proper form for your state check with an attorney or a local hospital. Once you have the form, discuss your health-care wishes thoroughly with the person who has agreed to take your DPA. This will allow him or her to make the decisions that you want. Be sure to discuss such things as end-of-life care, resuscitation, and the use of feeding tubes. Also, discuss your feeling about organ donation.

A living will is a legal document that goes into effect if you become terminally ill. It generally describes what care you want in given situations and does not appoint a person to act on your behalf.

Regardless of the type of advance directive you choose, I urge you to be very explicit about your desires. It’s crucial that you distinguish between the care you’d want if you’re terminally ill and what would be acceptable if you have a serious illness from which recovery is possible.

Young and single people like you are especially prone to accidental injury. Having a DPA or a living will can assure that your wishes are respected if you’re ever involved in a serious accident that leaves you incapacitated. I think it’s very important that all adults have one of these health care documents.

Family Medicine® is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701, or via e-mail to readerquestions@familymedicinenews.org. Medical information in this column is provided as an educational service only. It does not replace the judgment of your personal physician, who should be relied on to diagnose and recommend treatment for any medical conditions. Past columns are available online at www.familymedicinenews.org.