Why do you need an advance directive?

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 to get it. In most cases, treatment can be given only if you agree to it. Still, this right is not absolute. For example, if you need immediate or emergency care, the doctor may go ahead with treatment even if you can’t take in information and agree (consent) to be treated.

It’s also generally accepted that a competent (mentally able) adult may refuse medical testing or treatment if they understand the likely outcomes of refusing. This is sometimes called informed refusal. A competent adult patient may also ask that such treatment be stopped, even if it means they will die. See our document called Informed Consent to learn more. You can read it on our website at www.cancer.org, or call us for a free copy.

Advance directives are for times you can’t speak for yourself

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 can’t do so yourself. An advance directive gives you a better chance of having your wishes carried out, even if you can’t talk to the doctors about what you want.

An advance directive will not affect the type or quality of your care while you can voice your own decisions. It only comes into play when you can’t.

Sometimes, family members make medical decisions for spouses, parents, or adult children who can’t speak for themselves. Whether this type of informal arrangement will be accepted most often depends on the doctor 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 can’t speak for her- or himself. However, if there is disagreement between family members it can complicate and delay decision-making.

Even though others may be able to make health care decisions for you without an advance directive, they 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 can’t 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’ll need to find out what your state allows and requires. You can get more information from the sources listed in the “To learn more” section.

The American Cancer Society medical and editorial content team

Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Last Medical Review: May 21, 2015 Last Revised: May 18, 2016

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