Finding Your Way: Talking About End-of-Life Treatment Decisions

Advance directives based on where you live

There are some differences in advance directives based on the state where you live. Be sure to check with your doctor or a person familiar with these issues as they apply to your state.

Types of advance directives worth considering include:

• A living will, which is a formal legal document, authorized by state laws, that describes the kinds of medical treatments you want or do not want if you become incapacitated. It can be as specific or general as you wish.

• A durable power of attorney, also known as a health care proxy, which is a document that lets you designate a person to make treatment decisions for you if you cannot make those decisions. You’ll want to alert your proxy that you have given him or her this responsibility and talk about your wishes.

• A do-not-resuscitate (DNR) order, which is a document that directs what measures should or should not be taken on your behalf in events such as cardiac or respiratory arrest. Typically, a DNR order is directed to emergency medical services or other first-responders.

Talking about our concerns and taking steps to address them remains solid advice throughout life, even as we anticipate its end.

I’m Dr. Carolyn Clancy and that’s my advice on how to navigate the health care system.

Carolyn M. Clancy, a general internist and researcher, is an expert in engaging consumers in their health care. She is the director of the U.S. Agency for Healthcare Research and Quality.