Ten myths about health care planning

Paulette Brown

To encourage advance health care planning, April 16 is National Health Care Decisions Day. Most adults put off planning and may be confused by conflicting information and myths about advance health care planning.

Let’s clear up a few common myths:

■Advance directives are only for older people.

False. It is true older people are most likely to use advance directives, but every adult needs one. You never know when an accident or injury might leave you temporarily unable to communicate. Young adults should at a minimum name someone to make health care decisions when they can’t.

■You have to use your state’s statutory form for advance directive to be valid.

False. Most states do not require a particular form for advance care directives, but they do have special rules on how directives should be signed to be valid. An elder law or estate planning attorney can tell you what is required in your state.

■Advance directives are legally binding, so doctors have to follow them.

False. The decision on treating or not treating is based on the doctor’s assessment of your medical condition. Doctors may ignore the instructions in an advance directive if they consider them to be medically inappropriate or they have an objection of conscience. The only reliable strategy for having your desires followed is to make sure your doctors are willing to support your wishes, and then document them.

■An advance directive means “do not treat.”

False. An advance directive can describe both the treatment one wants and what one does not want. Ending life-saving or life-prolonging care is done only when there is no hope of recovery.

■If I name a health care agent, I give up the right to make my own decisions.

False. As long as you have the ability to do so, you are in charge of your health care decisions.

■I should wait until I am sure about what I want before signing an advance directive.

False. While you may not be ready to contemplate the end of life, you should appoint a health care agent. Your directives can easily be updated as your wishes change.

■Just talking to my doctor and family about what I want is not legally effective.

False. Meaningful discussion with your doctor and family is the most important step. But the best strategy is to combine talking with documentation, and make sure all parties have a copy.

■Once I give my doctor a signed copy of my directive, my task is done.

False. You need to make sure your doctor understands and supports your wishes, and that all of your health care providers are aware of your directive and have a copy. You should also review your wishes when any of the Five D’s occur: a new Decade in age, the Death of a loved one, Divorce, a Diagnosis of a significant medical condition, or a Decline in your medical condition.

■If I am living at home and my advance directive says I do not want to be resuscitated, EMS will not resuscitate me if I go into cardiac arrest.

Usually false. If you are terminally ill and do not want to be resuscitated, you should talk to your attorney and health care provider about an out-of-hospital do-not-resuscitate order. If you create one, you should talk to your local EMS providers to see if they will honor it, and your health care providers on what to do if EMS will not honor the order.

■You must have a living will to stop treatment near the end of life.

False. Treatment that is no longer leading to stable or improved health can be stopped without a living will, if agreed to by you, or your health care decision-maker and your doctors. However, the benefit of a living will is that it allows you to leave instructions beforehand about the health care you want, or do not want, when death is imminent.

Paulette Brown is president of the American Bar Association. This has been adapted from InsideSources.