What Are Advance Directives?

Advance directives are legal documents that allow you to express your healthcare preferences and make decisions about medical treatment in the event that you become unable to communicate or make decisions for yourself. These documents are legally binding in New York State, and can only be executed when you are of sound mind and able to make informed decisions.

The Different Types of Advance Directives

In New York State, there are two types of advance directives you create with an attorney: a healthcare proxy and a living will. In addition, there are two types of advance directives you create with a medical professional: Medical Orders for Life-Sustaining Treatment (MOLST) and a Do Not Resuscitate (DNR). The MOLST and DNR are intended for individuals with serious health conditions who may face life-threatening medical situations and want to make their treatment preferences known to health care providers.

Healthcare Proxy

A health care proxy is a document that states who will make medical decisions if you lack the mental capacity to make them on your own. In some states, this is referred to as a “medical power of attorney”, but in New York it is a Health Care Proxy.Some choose to sign a health care proxy when they are creating their estate planning documents. Others are prompted to sign such a document when they are going into the hospital for a procedure. A lack of mental capacity can be temporary, for example if someone is under anesthesia. A person can also suffer long-term loss of capacity from dementia or some other cognitive impairment.

Choosing a health care agent can be difficult. The best health care agent is someone who knows your wishes and who you believe will act as you would, making the choices you would make. Remember, this person is substituting their judgment for your own.

Living Will

A living will is a companion document to the health care proxy and serves as the "roadmap" for your agent. A Living Will more specifically directs the substituted decision-maker in their actions. It serves as your voice when you are unable to speak for yourself and are in an irreversible state, with no reasonable expectation of recovery. The living will often directs an agent to withhold or withdraw treatments if recovery is not expected. The document can list specific treatments to be withheld, including dialysis, antibiotics, and a feeding tube.

Keep in mind that, the living will can also direct the opposite: that someone be kept alive by all measures necessary.