April 16 is National Healthcare Decisions Day, a day physicians dedicate to encouraging people to create an advance directive, a document that outlines medical procedure preferences in scenarios where a patient is incapable of making the decision.
Several years ago, the Allegheny County Medical Society (ACMS) and the Allegheny County Bar Association (ACBA) collaborated to create an advance directive template as a public service. Pennsylvania advance directive law is established by state statute, and forms like this one help patients document their wishes in a way that aligns with that legal framework.
Over time, changes in law and practice made it important to revisit and update advance directive forms so they remained current and useful.”So, ACMS and ACBA got back together and worked to revamp the form.
Advance directives include three key components:
- The healthcare agent
- The living will
- Organ donations
“The healthcare agent, sometimes called a healthcare power of attorney, is someone who, if you ever become unable to make healthcare decisions on your own, they can make those decisions,” said Todd M. Hertzberg, MD, ACMS member and diagnostic radiology specialist. “It never takes away your right, but it puts someone in place if either you’re unable to or unwilling.”
It is crucial to have a conversation with a potential healthcare agent before adding them to confirm that they will feel comfortable in high-stress scenarios and are aware of one’s preferred medical preferences.
These preferred medical preferences should also be specified in the second part of the advance directive; the living will. The most common of these are do-not-resuscitate orders and tube feedings.
The third category, organ donations, is one of the most important and misinformed parts of the advance directive. Humans can donate many organs, from common ones like lungs, heart, and kidneys to skin and eyes.
“A common myth is that if I donate my organs, they’ll let me die quickly,” Dr. Hertzberg said. “You will hear ‘They won’t try to save me so my organs can be donated,’ and that is absolutely not true.”
In the United States, there are not currently enough organs for everyone who needs them. More than 100,000 people in the United States are currently waiting for an organ transplant, underscoring the ongoing need for donors.
There is also a strong need for a diverse donor pool. While organs are not matched strictly by race or ethnicity, shared ancestry can sometimes improve the chances of finding a compatible match, which is why outreach in Black and Hispanic communities remains especially important. “With organ donation, you can have a really big impact on someone,” Dr. Hertzberg continued. “Your driver’s license is not good enough. It’s better than nothing, but checking the organ donation box on your driver’s license does not allow everything. It is also helpful to discuss your wishes with your family and include them in your advance care planning documents.”
It is generally recommended to create an advance directive once reaching adulthood and having a good idea of where your health stands, but it is never too early to be prepared. After creating the directive, it can be changed as many times as desired.
Download an example of the advance directive form here.