Make an Advance Directive for Your Medical Care
Dan Morhaim writing on staying in control when you’re ill…
It will happen to you, someday.
You’re going to be in the hospital for some reason…and you won’t be able to talk or reason intelligently.
Maybe you got knocked out cold from a spill…or you’ve got a fever that’s gone too high and aren’t in your right mind…or some illness has rendered you mute.
Whatever the reason, you’re not in a position to make your wishes known. As an ER doctor, I’ve seen it plenty of times – more than I’d like to count.
In that situation, who do you want making decisions for you?
A loved one who cares about your well-being?
A hospital bureaucrat who cares about the bottom line?
Or an overworked doctor with too many patients, always balancing medical advice against the risk of lawsuit?
Guess what – if you don’t have an Advance Directive, literally anyone could end up making life-and-death decisions for you.
Not to mention, potentially choosing a path that leads you and your family to bankruptcy.
We all want to lead independent lives. Complete lives.
And without an Advance Directive, you’re giving up a huge amount of control over your life…at one of its most crucial points.
What is an Advance Directive? I’ll get to that in second.
First, let me show you why this little – free! – piece of paper is so important.
Without an Advance Directive, here’s what can happen…
You could be subject to all sorts of expensive and painful medical procedures that will run up the bill (and leave you bankrupt.) Perhaps without hope of recovery, all you’re doing is prolonging your personal torture, while running down your wealth.
Conversely, you could be cut off from life-extending or life-saving treatment because no one knows if you can afford it, or want it. Maybe you’d be able to recover just fine in a few months…but a delay in treatment early on wipes away that chance.
Without an Advance Directive, every decision is harder, and takes more time. And – especially early in an illness – time is a luxury you just don’t have.
Imagine that you are unable to communicate because you’re on too many painkillers to think clearly, or you’re unconscious after surgery, or you’ve had a stroke.
Will you get antibiotics if needed? A CT or MRI scan? Tubes inserted in your most sensitive areas? Placed in a nursing home? CPR? You’ll be lying there helpless, possibly aware of what’s going on but unable to do anything about it. Who wants that?
Advance Directives are documents that are free, legal in every state, easily obtained, and can be changed quickly and simply. An Advance Directive comes into use only when you can’t make medical decisions for yourself.
Advance Directives have three parts.
The first part outlines how much medical care you want under various circumstances. On one extreme, it could be the full court press of the modern medical system. On the other hand, it could be pulling the plug when life has no more meaning. But most of us choose the middle path: keep me going, comfortable, pain-free, and give me as much out of life as I can get, but when the end comes, let nature take its course.
The second part designates someone to make medical decisions for you when you can’t. This is your health care agent. Typically that person is a spouse, adult child, or sibling. But it could be anyone you choose.
It should be someone whose judgment you trust and who has your best interests at heart consistent with your values and beliefs. You should have a discussion with that person when you are well, and you should assure them that they are not responsible for your health care bills.
You can also specify people you don’t want involved. There may be an annoying relative who makes everyone in your family crazy and angry. Your Advance Directive could make sure that person is kept away. And, without clearly specifying your health agent, literally anyone could wind up in charge of your case. You don’t want that.
The third part has to do with disposition of your body, organ donation, and other arrangements. As for me personally, I don’t want money spent on a fancy funeral or burial costing tens of thousands of dollars. I want a simple event, with a party to follow and to leave more money for my heirs and causes I support. I will donate my organs so others can live because, for me, it’s the right thing to do.
Filling out an Advance Directive is not something to put off until the last possible second. The three most famous cases of this in U.S. medical-legal history on this topic were women under 30.
Only you can complete your Advance Directive. As I mentioned earlier, forms are available from many sources, but I like mydirectives.com because it’s free, online, and includes excellent explanations of medical choices. You can change your Advance Directive whenever you like; the most recent one is the one that applies. After you fill it out, it needs to be readily available to the right people, the people you know and trust.
It’s hard to stand up to the medical system. We want the best it has to offer, but we want it on our own terms. To be sure you are protected, get an Advance Directive form. It’s completely free. Complete it. Share it. And then rest easy.
You’ve just completed one of the most important tasks everyone ought to do: you’ve taken back control of your health.
Editor’s Note: Dr. Dan Morhaim is author of The Better End: Surviving (And Dying) On Your Own Term’s in Today’s Modern Medical World.
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