Why do we need advance directives?

You have a right to be informed and decide for yourself

Adults have the right to control their medical treatment as long as they are mentally able to do so. You can choose which course of treatment you would like from those the doctor offers. You can choose the kind of treatment (aggressive, comfort care, or even none). This right is called informed consent and every state recognizes it.

Informed consent means that the doctor or nurse explains the purpose, benefits, risks, and alternatives of the treatment before you decide whether you choose to do it. In most cases, treatment can be given only if you agree to it. Still, this right is not absolute; for example, if you are unable to take in information or give consent and you need immediate or emergency care, the doctor may go ahead with treatment.

It is also generally accepted that a competent (mentally able) adult may refuse medical treatment that keeps him or her alive. A competent adult patient may also ask that such treatment be stopped, even if he or she dies as a result. Informed consent includes the right to refuse treatment, which is sometimes called informed refusal. See our document called Informed Consent to learn more. You can read it on our Web site at www.cancer.org, or call us for a free copy.

The role of advance directives

Advance health care directives (also called advance directives) are a way for you to give consent for certain situations where you might want or not want treatment. They can also be used to appoint someone to make decisions for you if you cannot do so yourself. An advance directive gives you a better chance of having your wishes carried out, even if you are unable to talk to the doctors about what you want.

Sometimes, family members make medical decisions for spouses, parents, or adult children who cannot speak for themselves. Whether this type of informal arrangement will be accepted depends on the medical provider, and which state you live in. Many US states have passed laws that say which family members (in a listed order of priority) may act on behalf of a person who cannot speak for her or himself.

Even though others may be able to make health care decisions for you without an advance directive, these documents can give you more control over those decisions and who makes them. Some types of advance directives contain written directions or guidance about future medical care. Another type of directive lets you choose a proxy (a substitute person, also called an agent or surrogate) to make decisions for you when you cannot make them for yourself.

General information about different advance directives, like health care power of attorney, living wills, do-not-resuscitate orders, and other agreements like these will be reviewed here. These documents apply only to your health care decisions and do not affect financial or money matters. Because the laws on these documents vary by state, you will need to find out about what your state requires. You can get more information from the sources listed in the “To learn more” section at the end of this document.