Advanced Directives

Do your family and friends know your medical wishes if you are unable to communicate? 
Ohio and federal laws give adults who are capable of making their own decisions the right to decide how to proceed with medical treatment. However, sometimes people may not be able to say what they want due to health-related conditions. This is why advance directives are important. 

What are advanced directives?

Advance directives are documents where you write down and sign in advance your personal choices regarding your medical treatment. You can cancel or change your advance directive at any time. The most common types are durable power of attorney for health care, living will and DNR. 

Living wills

A living will is a document that tells your doctor or other health care providers whether or not you want life-sustaining treatments if you are in a terminal condition or a permanently unconscious state. It takes effect while you are living and only relates to your health care decisions—not your money or property.

Durable Power of Attorney for Health Care (DPAHC) 

A DPAHC is a legal document that allows you to appoint another person to speak for you regarding medical decisions if you are unable to make decisions yourself. Usually your spouse or members of your family are good choices to act as your spokesperson. 

Do Not Resuscitate (DNR) 

DNR is a directive issued by a practitioner (i.e., doctors order) that specifies that CPR should not be administered if/when the heart stops. Ohio law provides for a permanent order to be in place for those who are elderly, very sick or terminal. A doctor must sign this advance directive for it to be effective. 

What happens if I don’t have and advance directive? 

You will receive medical care, but you may get more treatment than you want. If you are 18 years or older, and cannot speak for yourself, the doctor will look to the following people in the order listed for decisions about your care: 

  1. Legal guardian
  2. Spouse
  3. Adult children
  4. Patient’s parents
  5. Adult siblings
  6. Next of kin

If you are making decisions for a patient... 

It is important to make medical choices for your loved one if he/she is unable to communicate. There are two ways to make these decisions. If you have talked about what your loved one would want, follow those wishes. If they have advanced directives (written instructions) you need to see that the instructions are followed. This is called “substituted judgment.” If you have not talked about what they would want, or there are no written instructions, you need to make choices based on what you think is in their best interests. It is important to listen to the medical team and make your decisions based on what you believe your loved one would want. This is called “best interests standard.”