What are Advance Directives?

These are legal documents (such as a “living will”) signed by a living competent person in order to provide guidance for medical and health-care decisions (such as the termination of life support and organ donation) in the event that the person becomes incompetent to make such decisions

Everyone should have the right to make their own health care decisions. Advance directives help people communicate their treatment choices when they would otherwise be unable to communicate them verbally.

But what happens if you unable to make health care decisions for yourself because of injury or illness?
Imagine that you are admitted to hospital, terminally ill with cancer and are confused.
Who will decide whether you should have CPR (cardiopulmonary resuscitation) if your heart should stop suddenly?

Or what if you are involved in an accident which leaves you in a coma,
Who will decide whether you are to be kept alive by a ventilator?

Or what if you develop Alzheimer’s disease and you contract a serious infection in a nursing home. Who will decide whether or not you will be hospitalized and what treatment you will be given?

There are many types of Advance Directives Some such as a “Living Will”, tell medical staff things that the patient does not want as a treatment option. While others such as a “Medical Power of Attorney” tell medical staff who should be considered as being responsible for making medical decisions on a patient’s behalf.

You can stay in charge of your healthcare, even though you can no longer make decisions for yourself by producing a document called an “Advance Care Plan”.

What is the difference between a Living Will and an Advance Care Plan?
A “Living Will” is the term used in Tennessee’s prior law. In 2004, Tennessee law changed the name of the form “Living Will” to “Advance Care Plan”.
A Living Will is a document stating that if its author becomes terminally ill, his or her life should not be prolonged by artificial means, such as a life-support machine, or other forms of treatment that the author does not want to be performed. In short a living will generally tells medical providers what forms of treatment should not be undertaken. In contrast an Advance Care plan generally also tells medical providers what treatments a patient does want to be undertaken, and it can also include the appointment of a Health Care Agent.

What is a Medical Power of Attorney?
It is a written document that authorizes a trusted person to make decisions about personal medical care if the person is unable to make decisions for themselves. A “Medical Power of Attorney” is a term used in the State’s law prior to 2004. Since 2004 this is referred to as an “Appointment of Health Care Agent”.
An Appointment of Health Care Agent is another type of advance directive that allows you to name a person to make health care decisions for you if you are unable to make them for yourself.
An Appointment of Health Care Agent form is included at this web site. You may complete an Appointment of Health Care Agent form by filling out this form and having it properly witnessed and/or notarized.

How is the Appointment of Health Care Agent different from the Advance Care plan?
An Advance Care Plan tells your physician how you wish to be treated if you are terminally ill or permanently unconscious and unable to make decisions for yourself. An Advance Care Plan can tell your doctor what you do or do not want unless you write in other specific instructions. It is a written verification of decisions that you have made yourself.
In contrast, the Appointment of Health Care Agent allows you to choose someone else to make health care decisions for you should you become too sick to make them for yourself. This person is referred to as your Health Care Agent.
Your Agent can make any health care decision that you could make if you were able. A Health Care Agent allows you to give specific instructions to your medical team about the type of care you would like to receive.
The Appointment of Health Care Agent allows your decision maker to respond to medical situations that you might not have anticipated in an Advance Care Plan and lets someone make decisions for you with knowledge of your beliefs, values and wishes.

I already have a Living Will? Do I need to create an Advance Care Plan?
Because the Advance Care Plan includes both the Appointment of Health Care Agent alongside other Advance Directives. This makes the Advance Care plan a more flexible document. It allows you to name someone to make decisions for you (just like a Medical Power of Attorney) and provide directives for care if your quality of life becomes unacceptable (just like an expanded “Living Will”).
Some people, however, do not have someone whom they trust or who knows their values and preferences. These people should still consider creating an Advance Care Plan, as it does not have to have a named “Health Care Agent” in order for it to be effective.
Generally an Advance Care Plan has more detailed instructions for medical staff to go by, and may better express your medical desires; so you may want to switch to this new form of Advance Directive. If you choose not to create a new Advance Directive form, the old form of directive will be still be honored.

Can I still make my own health care decisions once I have created an Advance Directive?
Yes. Your Advance Directive does not become effective until you are incapable of clearly expressing your own wishes. As long as you can do this, you have the right to make your own decisions.

Do I need a lawyer to create an Advance Directive?
No. Advance Care Plan and Appointment of Health Care Agent can be created without the assistance of a lawyer

Who should witness my signature on my Advance Directive?
Your witnesses must be a competent adult who is not the agent and at least one (1) witness not related to you by blood or marriage or adoption. Choose persons who will not inherit any of your property.

How can I find a Notary Public if I choose to have my signature notarized?
Businesses such as banks, insurance agents, government offices, hospitals, doctors’ offices, and automobile associations have or can direct you to a notary public.

What should I do with my Advance Directive after I sign it?
After your Advance Directive is signed, witnessed and/or notarized, give one copy each to your agent, your successor agent, your doctor, and your local hospital. Keep the original document in a safe location where it can be easily found. Your safe deposit box may not be the best place for your Advance Directive unless you are certain someone close to you has access to the safe deposit box if you become incapacitated.
Make sure your agent knows where the original is so it can be shown to your doctor on request. However, a photocopy of your Advance Directive is legally valid.

What if my doctor or my family do not agree with my treatment choices or health care decisions?
You can prevent this from happening by talking with your family and health care providers about your decisions and personal values and beliefs. If others understand your choices and the reasons for them, there is less of a chance that they will challenge them later.
If you have made your wishes known in an Advance Directive and a disagreement does occur, your doctor and your agent must respect your wishes. You have a right to refuse or consent to health care. If your doctor cannot comply with your wishes, he or she must transfer your care to another doctor.
The consent or refusal of your Appointed Health Care Agent is as meaningful and valid as your own. The wishes of other family members will not override your own clearly expressed choices or those made by your agent on your behalf.

What if I change my mind about who I want to be my agent or about the kind of treatment I want?
You should review your Advance Directive periodically to make sure it still reflects your wishes. The best way to change your Advance Directive is to create a new one. The new Advance Directive will automatically cancel the old one. Be sure to notify all people who have copies of your Advance Directive that you completed a new one. Collect and destroy all copies of the old version.

How Do I get Advance Directive Forms?
Click Here to download a copy of an Advance Care Plan