Documents Can Direct Care if You Can't

Q:  What are advance directives? Is it possible for me to prepare them myself, without paying a lawyer to help me?

A:  As this is an important and complicated topic, I'm glad to have the help of Dr. David Schiedermayer, an ethicist and former Professor of Medicine at the Medical College of Wisconsin.

Advance directives are legal documents outlining your preferences for health care. The power of attorney for health care, or PAHC, is more flexible and useful than the living will. The PAHC has all the options of a living will plus allows for naming an agent. An agent is someone you designate to make health care decisions for you if you are unable and is usually a spouse or family member.

The PAHC becomes active if an illness or disability leaves you unable to make health care decisions. The living will becomes effective when two physicians diagnose a persistent vegetative state or a terminal state - when death is expected in six months or less.

The medical setting is a good place for a person to complete an advance directive. Completing an advance directive does not require the presence of an attorney or notary public. Hospital chaplains or social workers or neighbors or friends may be witnesses, but in most states, doctors, nurses and other employees of health care institutions cannot witness your signature.

You can get PAHC forms at any most government and doctor's offices. In addition, the Wisconsin Department of Health and Family Services (DHFS) has three advance directive forms available to the public online or by mail. These are:

• Declaration to Physicians (Wisconsin Living Will)
• Power of Attorney for Health Care
• Power of Attorney for Finance and Property

You can obtain copies of the forms either by printing them from the DHFS website or by sending a stamped, self-addressed business-sized envelope to:

Living Will/Power of Attorney
Division of Public Health
PO Box 309
Madison, WI 53701-0309

For more information on this topic, see the HealthLink articles 'No Code' Does Not Mean No Care and Advance Planning is Crucial in Health Care Emergencies.

Julie L. Mitchell, MD, MS, is an Assistant Professor of Medicine at the Medical College of Wisconsin. She practices internal medicine at the Froedtert & Medical College General Internal Medicine Clinic - East. Her column appears in the Milwaukee Journal-Sentinel.