Advance directive

What it means

Advance directive is an umbrella term. It usually covers a living will, which records what treatment you would want, and a healthcare power of attorney or proxy, which names a person to decide for you.

Many states combine both into a single form.

Why it matters

Without one, decisions fall to whoever the state's rules designate, which may not be the person you would choose — and disagreement between family members has no tie-breaker.

A directive that nobody can find does nothing, so where it is kept matters as much as what it says.

When you are likely to meet it

• When a parent is admitted to hospital.
• When a doctor asks whether there is a healthcare proxy.
• When planning ahead, alongside a will and a financial power of attorney.

The documents that speak for you about medical care

Four documents that are constantly confused, doing four different jobs.

A wish is not an order. The first two say what you want; the second two instruct the people in the room.

How this varies by state

Names, forms and witnessing requirements differ by state, and not every state honors another state's form automatically.

Related terms

• Anatomical giftA legally binding decision to donate organs, tissue or a body, which the family generally cannot override.
• DeclarantThe person who signed the advance directive — named this way because the document speaks for them once they cannot.
• Do-not-resuscitate orderA medical order saying that if the heart or breathing stops, no attempt at resuscitation should be made.
• Health care agentThe person named in a health care proxy to make medical decisions when the patient cannot.
• Health care proxyA document naming somebody to make medical decisions for you if you cannot make them yourself.
• HIPAA authorizationWritten permission for a doctor, hospital or insurer to share somebody's medical information with a named person.
• HospiceCare that focuses on comfort rather than cure, for someone expected to live six months or less.
• Hospice vs palliative carePalliative care can start at any time and alongside treatment. Hospice starts when the goal is comfort rather than cure.
• Living willA written statement of what medical treatment you would and would not want if you could not say so at the time.
• Palliative careCare aimed at relieving symptoms and stress, available at any stage of a serious illness.
• POLSTA medical order form covering more than resuscitation, signed by a clinician, meant to travel with the patient between home, hospital and care facility.
• Power of attorneyA document letting somebody act for you while you are alive — and which stops working the moment you die.
• Witness requirementsWho must watch a document being signed, how many, and whether they may also benefit from it. Getting this wrong can void the whole document.

Sahvelo guidance that uses this

• Advance directives
• HIPAA authorization