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Medical Decisions: Advance Directives and Living Wills


What is an advance directive?
Who should have an advance directive?
At what point does my agent for health care start making decisions for me?
Do my doctor or my agent have to follow my advance directive?
How do I make an advance directive?
Can anyone act as a witness?
Who can be my agent?
What should I do once I have filled out my advance directive?
Can I change my advance directive?
Where can I get more information about advance directives?


What is an advance directive?
An advance directive is a written document that lets you plan for your medical care when you
can't make decisions for yourself.  Advance directives used to be called a Durable Power of
Attorney for Health Care, or a Living Will, or a Terminal Care Document.  An advance directive
lets you:

     1)   Pick someone to make health care decisions for you (your "agent");

     2)   Write down what kind of medical care you want;

     3)   Decide the kind of treatments you want for end of life care;

     4)   List who you would want to be your guardian, if you need one, and decide how
          you would want your family to be involved in your care in the future;

     5)   Give burial instructions, decide to be an organ donor, and include any other
          instructions or information about your health care that you want.

Who should have an advance directive?
Everyone should have an advance directive.  An advance directive is not just for seniors or
people at the end of life.  An advance directive can help you any time you can't make medical
decisions for yourself.  No Vermont law says that your spouse can make medical decisions for
you.  So if you want your spouse to make medical decisions for you, you should name your
spouse as your agent in an advance directive.

At what point does my agent for health care start making decisions for me?
Your agent can make health care decisions for you only when you can't make medical decisions
for yourself.  You have the right to make any medical decisions for yourself as long as you have
the capacity.  If you want you can allow your agent to start making decisions now, or ask your
agent to help you make decisions now.

Do my doctor or my agent have to follow my advance directive?
Yes.  All medical providers are required to follow your advance directive.  Your agent should
make decisions for you based on what you wrote down in your advance directive or what you
told them you wanted.  If you did not write down any treatment wishes, your agent should try to
make the decisions that you would have made for yourself.

How do I make an advance directive?
You can have an attorney prepare an advance directive for you or you can use one of these forms: Advanced Directive for Health Care: Long Form or Advanced Directive for Health Care: Short Form.
Your advance directive can be simple (short form) or detailed (long form). An advance directive
must be signed and witnessed properly. Once your advance directive is drafted and you are
satisfied with its contents, you must sign the advance directive in front of two witnesses, who
must also sign the document. It does not need to be notarized.

Can anyone act as a witness?
No.  Some people may not be a witness.  Your agent and your immediate family members cannot
witness your advance directive.  Your immediate family includes your spouse or partner, your
parents, your siblings, your children or grandchildren, or your "reciprocal beneficiary" if you
have one.
 
Who can be my agent?
You can pick anyone to be your agent, except your agent can't be your doctor or health care
provider.  You should pick someone you trust and who knows you well.  Your agent will make
health care decisions for you when you no longer have the capacity to make your own decisions.

What should I do after I fill out my advance directive?
Your advance directive must be signed and dated in front of two witnesses. You should give a
copy of your advance directive to the person you picked as your agent.  You may want to give a
copy to other family members so they know about it.  You may want to give a copy to your
doctor and to any nursing home, hospital, or other place you may get medical care.

Soon, the Vermont Department of Health will be able store your advance directives online in the
advance directive registry.  The registry is free.  Doctors and hospitals are required to check the
registry, so that is a good way to make sure that they will know about your advance directive.
You can submit your advance directive to the registry by mail.  Here is more information about
the Department of Health's advance directive registry: http://healthvermont.gov/vadr/index.aspx.

Can I change my advance directive?
Yes.  You may change or revoke your advance directive at any time.  You can tear it up if you
want to revoke it.   You can tell your doctor you want to revoke it or change it.  The best way to
change it is to write a new advance directive.  After you write the new advance directive, you
should give it to all the people who have the old one.  You should tell them that you revoked the
old one.

Where can I get more information about advance directives?
The Vermont Ethics Network publishes a good booklet about advance directives.  They also have
forms you can download.  You can get more information from them here:
http://www.vtethicsnetwork.org/

The Department of Health also has information about advance directives.   They have forms you
can download and information on the advance directive registry.  The Department of Health
website is here: http://healthvermont.gov/vadr/index.aspx

You can also call Vermont Legal Aid for forms and booklets about advance directives.  Seniors
may be able to get assistance with their advance directive from the Senior Citizens Law Project at
Vermont Legal Aid, or may be referred to a private attorney who has agreed to help seniors with
an advance directive for a reduced fee.  You can get help from Vermont Legal Aid by calling
(800) 889-2047.
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