Skip to main content
Contact Us 800.227.2345 Help Sign Up For Email

Managing Cancer Care

Back
Download Section as PDF

Frequently Asked Questions About Advance Directives

Completing advance directives is part of a process called advance care planning. This requires you to make tough decisions about the medical care you would or would not want if you are near the end of your life (terminally ill) or are unconscious and unlikely to wake up again.  

On this page
[show] [hide]

The best time to make an advance directive is before you need one. In other words, before you become too sick to make your own decisions about what medical care you want to get or refuse.

Yes, you can change your mind at any time about what's written in your advance directive. You can also revoke it (take it back) at any time.

It is recommended that you review your advance directive every so often to make sure your wishes are still the same. For example, you might want to make a change if you have a major health change, a major family change like a divorce, if something happens to your health care proxy or they become unwilling to be your proxy, or if an existing health condition or illness gets worse.

If you change or cancel your advance directive, be sure to let your health care team, loved ones, and your health care proxy know. You will also need to update your advance directive forms and give them new copies . This will help prevent confusion if you are unable to make your own decisions.

End-of-life decisions are those you can make now about how you wish to be treated when you are dying. End-of-life decisions are part of a living will and can include whether to accept or refuse treatments that might prolong your life.

An advance directive is one way to let others know about your health care wishes. It’s important that those close to you understand what you want, so it is as easy as possible for them to carry out your wishes.

A terminal illness is one that can’t be cured and is expected to result in death at some point. Examples of terminal illnesses include advanced cancers, multiple organ failure, or some massive heart attacks and strokes. Definitions of terminal illness can be different from state to state.

Life-sustaining medical treatment is any medical intervention or medicine that would prolong life in a terminally ill person. It will not, however, get rid of the problem that is causing the person to die. These might include:

  • CPR (cardiopulmonary resuscitation) including use of a defibrillator
  • Breathing machines (ventilators)
  • Medicines such as antibiotics
  • Nutrition and hydration (food and liquids) given through feeding tubes or IVs

Measures used to provide comfort or ease pain are not usually considered life-sustaining. In some states, tube feedings and IV fluids are considered comfort measures. But states have different definitions of life-sustaining, so be sure you know what your state says.

If you have any type of advance directive, let your health care provider know and give them a copy for their records. You might also tell people close to you that you have one and where it’s kept. Give copies of your advance directive to your proxy, your partner or spouse, other family members, and friends who might be contacted if you become seriously ill.

Even though advance directives are legal documents, there are times when a health care provider might not have to follow a decision made by your health care proxy or as described in your advance directive. For example:

  • When the decision goes against the health care provider's conscience.
  • When the decision is against the health care institution’s policy.
  • If the decision violates accepted health care standards.

In such cases, the health care provider or facility must tell you right away. The health care provider or institution may help transfer you to another facility that will honor your decisions.

To avoid these situations, discuss your wishes with your health care provider ahead of time and document them. This will help make sure your health care team is clear about what you want and is willing to support your wishes. This will also help make sure that your wishes are within the institution’s health care standards.

Your advance directives are valid in an emergency room only if the staff there knows about them. In serious emergency situations, it may not be possible for health care workers to know that you have an advance directive before emergency medical care is given.

If you have specific wishes that you would like to be carried out in case you have an emergency, you might want to talk to your health care team about filling out a physician orders for life-sustaining treatment (POLST) form.

If you don’t have an advance directive and become unable to make medical decisions for yourself, you could be given more intensive medical care than you would have wanted. If you don’t have a living will or durable power of attorney for health care, the health care provider may ask your family about your preferences for treatment.

Some states have passed family agency acts that choose which family members (listed in order of priority) may act on behalf of a patient if you don’t have an advance directive. But family members (especially those who aren’t close to you) might not know what you want.

Family members might also disagree on the care you should receive. This may cause delays or lead to you not getting the care you might have wanted. Sometimes, the courts can appoint a surrogate or proxy. This is someone a judge chooses to make decisions for you if you cannot make decisions for yourself.

A lawyer can be helpful, but most people don’t need one to write an advance directive. Some states have forms you must use, and all states have requirements.

To get copies of your state’s advance directive forms, check with your health care team or a hospital near you. Or you can find links to the forms on the American Bar Association  or on the CaringInfo websites.

Ask your health care team if they can help you make the decisions needed to complete your advance directive. They might also be able to give you copies of your state’s forms and help you complete them.  

If you have a lawyer, they might also be able to help you. They should know what your state requires and have access to sample forms.

You can also create a free advance directive, along with a will, on Giving Docs. Giving Docs is a safe, secure, free-for-life partner of American Cancer Society.

Most states have laws about what they will accept as a valid advance directive. Some states recognize an out-of-state directive if it meets the legal requirements of the state where you want to use it.

If you want to use an advance directive in a state other than the one in which you signed it, or if you want to have an advance directive in more than one state, it’s a good idea to check with a lawyer to avoid any problems.

No. You should receive the same quality of care whether you have an advance directive or not. Your advance directive only affects the types of care you receive – not the quality. And it only applies if you are not able to make decisions for yourself.

For a living will and a durable power of attorney for health care to be used, two physicians must confirm that you are unable to make medical decisions for yourself. They must also confirm that you are in a medical condition defined by your state law as a terminal illness or permanent unconsciousness.

Yes, you can have a living will and a durable power of attorney for health care. In some states, both types of advance directives are on the same form.

If you have both types of advance directives, make sure they don't conflict with each other. This can help prevent confusion about your wishes if you can't speak for yourself.

It might be difficult to honor an advance directive in the event of an emergency at your home. EMS (Emergency Medical Service) teams are required to try to revive and prolong life in every way they can.

Some states allow EMS teams to not resuscitate patients who have valid DNR or POLST forms at home. If DNR or POLST forms are honored in your state, speak with someone on your health care team about getting these forms filled out and signed to reflect your wishes in case of an emergency. They may also be able to help you get a wallet card, bracelet, or other DNR documents to keep when you are at home or not in the hospital.

Woman holding a child in her arms playing with a toy

Creating a plan

Making a plan can help provide peace of mind for you and your loved ones as you navigate your cancer journey together.

Giving Docs is a safe, secure, and free-for-life partner of American Cancer Society where you can access a suite of tools, including creating a free will, advance directive, and other essentials.
side by side logos for American Cancer Society and American Society of Clinical Oncology

Developed by the American Cancer Society medical and editorial content team with medical review and contribution by the American Society of Clinical Oncology (ASCO).

 

Agarwal R, Epstein AS. Advance Care Planning and End-of-Life Decision Making for Patients with Cancer. Semin Oncol Nurs. 2018;34(3):316-326. doi:10.1016/j.soncn.2018.06.012

American Bar Association. Tool Kit for Health Care Advance Planning. Accessed at https://www.americanbar.org/content/dam/aba/administrative/law_aging/2020-tool-kit-hcap.pdfon June 24, 2025.

American Society of Clinical Oncology. Putting your health care wishes in writing. Accessed at cancer.net. Content is no longer available.

Cohen MG, Althouse AD, Arnold RM, et al. Hope and advance care planning in advanced cancer: Is there a relationship?. Cancer. 2022;128(6):1339-1345. doi:10.1002/cncr.34034

National Alliance for Care at Home. Advance directives. Caringinfo.org. Accessed at https://www.caringinfo.org/planning/advance-directives/ on June 24, 2025.

National Cancer Institute (NCI). Advance directives.2024. Accessed at https://www.cancer.gov/about-cancer/managing-care/advance-directives, on June 24, 2025.

National Institute on Aging (NIA). Advance care planning: Advance Directives for Health Care. .2022.  Accessed at https://www.nia.nih.gov/health/advance-care-planning/advance-care-planning-advance-directives-health-care on June 24, 2025.

Silveira MJ. Advance care planning and advance directives. 2025. Accessed at https://www.uptodate.com/contents/advance-care-planning-and-advance-directives on June 24, 2025.

 

Last Revised: August 1, 2025

American Cancer Society medical information is copyrighted material. For reprint requests, please see our Content Usage Policy.

American Cancer Society Emails

Sign up to stay up-to-date with news, valuable information, and ways to get involved with the American Cancer Society.

Sign Up for Email

Help us end cancer as we know it, for everyone.

 
Charity Navigator 4-star rating button     BBB rating button    Candid rating button