There are no easy decisions toward the end of life. However, not thinking about what you would want in a medical catastrophes could put more stress on your loved ones.
Luckily, an Advanced Medical Directive is an estate planning document which can help empower your loves ones, remove red tape, and lift some of the uncertainty of medical decision making. Advanced Medical Directives combine a living will which outlines your medical care preferences with an appointment of durable medical powers so that your named agent will have the right to engage with healthcare providers on your behalf.
Many people get an Advanced Medical Directive drafted when they create the rest of their estate planning documents. Estate attorneys who are doing the work of making your Last Will & Testament and/or Living Trusts will often include an Advanced Medical Directive and Durable Power of Attorney (two other important estate planning documents) for free.
Every year, the Virginia State Bar has an annual awareness day called “Healthcare Decisions Day” where they encourage Virginia citizens to plan for their catastrophic or end-of-life medical care using these documents.
The Virginia State Bar has even made a few versions of a simplified Advanced Directive free to the public on their website. The idea is that you can print the form that best fits your needs, fill out the blanks, and provide a copy to your doctor and loved ones in case it is ever needed.
Currently, their free forms are:
Simplified Basic has a list of granted powers in Section I which largely just encompasses the ability to engage with your healthcare provider, Section II has the opportunity to accept or deny care which prolongs your life, and Section III has the ability to designate anatomical donations.
Simplified Combined is the same as Simplified Basic except that in addition to the Section I powers it adds the authority to “authorize admission to a health care facility for the treatment of mental illness,” and Section II has an added checkbox for you to develop a “Crisis Plan” in the event that you have a mental health disorder requiring institutionalization.
Special Provisions for Mental Health Conditions is just the mental health disorder sections of the Simplified Combined version.
Special Provisions for Pregnancy is the same as Simplified Basic except that in Section II it separates the situation where you are pregnant from all other situations in your decision to accept or deny care which prolongs your life.
Special Provisions for Mental Health Conditions and Pregnancy has all of what Special Provisions for Pregnancy has, but also has “Special Powers of My Agent to Authorize Health Care Over My Objection” for the purpose of mental illness.
Statutory Form is the most all-encompassing and assuming of their provided forms. It gives your agent the right to perform any healthcare decision you could have if you were capable of it. It even includes a section for you to list types of healthcare where the agent can authorize even if you protest. Furthermore, in Section IV it includes a statement that says that you direct that life-prolonging procedures be withheld or withdrawn so that you can die; this statement is the default and must be crossed out to be avoided.
If you don’t like any of the Advanced Medical Directives they have provided, they have a Advance Directives Checklist, which lists the legal requirements for a directive to be considered valid. They also have a handout Your Right to Decide which has further information about your rights. You could use these documents to write your own.
Lastly, they have provided the Advance Directive Tool Kit, which includes a worksheet to help you think about what you want and the steps to ensure thorough implementation.
It is important to note that if you choose to deny life prolonging procedures in your advanced medical directive than no one can over rule that except you. If your opinions are conditional on the circumstances, then you would likely do better giving your appointed agent your instructions outside of this legal document.
Advanced medical directives are most important for people who don’t have an immediate family member who will speak for them. Hopefully, these free estate documents make it easier for more people to be prepared.