Advance Medical Directives

The law recognizes that we have a fundamental right to consent to or refuse medical treatment. But what happens when we are unable to communicate our wishes with respect to medical treatment?

The law provides that we can execute certain documents in advance that can facilitate the process. Two types of advance medical directives, health care proxies and living wills, are discussed here.

What is a health care proxy?
A health care proxy is a document that appoints someone to be your health care agent. A health care agent can make medical decisions on your behalf.

When does the health care proxy become effective?
A health care proxy becomes effective only after a doctor determines that you are unable to communicate your wishes yourself, e.g. if you are unconscious or in a coma.

What decisions might the agent be called upon to make?
Some of the decisions your agent may be required to make include what medications to take or refuse or what procedures or surgeries to undergo.

Can the health care agent make a decision that is against my own wishes?
If you have previously communicated to your health care provider your wishes with respect to certain medications or procedures, your health care agent cannot overrule your decision once you lose your ability to communicate.

Does the health care proxy make the health care agent responsible for my medical bills?
No. You remain responsible for payment of medical services provided to you, whether you personally consented to them or your health care agent consented on your behalf.

Can my health care agent override my decision concerning organ donation?
No. Your health care agent cannot cancel your decision to be or not to be an organ donor.

Can my health care agent make decisions regarding end-of-life choices?
Your health care agent can make decisions with respect to end of life care only if you can show that you have communicated your intentions to the agent. A separate document called a Living Will can accomplish that.

What is a Living Will?
A Living Will is a document that serves as evidence of your wishes with respect to end-of-life care.

What are some of the issues a Living Will addresses?
A Living Will can express your wishes with respect to life-prolonging procedures and end-of-life treatment when it has been determined that you are in a persistent vegetative state or have no hope of recovery.

What are some of the issues I can address in advance?
You can use your Living Will to express your desire to withdraw or withhold life-sustaining treatment, such as artificial respiration, artificial hydration and artificial nutrition when you have no hope of recovery. You can also indicate a desire to be taken off medications, even antibiotics, if there is no hope for your recovery.

What about pain management?
You can use your Living Will to express a desire for maximum pain relief, even if that were to hasten your death.

Can I ever change my Health Care Proxy or Living Will?
A health care proxy and living will can be changed at anytime, so if you change your mind about certain procedures or wish to change your health care agent, you are free to do so.

Who has the ability to complete a Health Care Proxy and make a Living Will?
Anyone 18 years or older can make a Living Will or complete a Health Care Proxy. To be effective, the documents need to be executed and witnessed in conformance with New York State law.