Plan Ahead For Health Care
What is an advance directive?
Understanding Your Choices
FAQs
NYS Health Care Proxy Form
Where to keep your Advance Directive?
A safe and confidential place to store your advance directive documents.
They can be seen when needed to assure your wishes are known and honored.
What is an Advance Directive?
Do you have an advance directive?
Every time you go to a medical facility someone will ask you if you have an advance directive. The term advance directive refers to several different types of documents: Health Care Proxy, Living Will, and Do Not Resuscitate Order. Any of these documents gives instructions for future health care in the event you are not able to make decisions for yourself.

Health Care Proxy

Living Will

Do Not Resuscitate Order

Medical Orders for Life-Sustaining Treatment (MOLST)



The best way to protect your treatment wishes and concerns is to appoint someone you trust to make decisions for you. New York State Proxy Law allows you (if you are eighteen or older) to pick a person to be your health care agent to speak for you if you are no longer able to speak for yourself. Your health care agent will be allowed to make all of your health care decisions including whether you will have any medical tests, treatments, or surgeries. When the time comes, your agent will also decide to use or remove treatments that may extend your life. Your agent needs to know your wishes about artificial nutrition and hydration (food and water provided by a feeding tube), or he or she will not be allowed to refuse or agree to these measures for you.

Your agent will start making decisions for you when doctors decide that you are not able to make health care decisions for yourself. To plan ahead for your health care or request a copy of the Sharing Your Wishes Planning Guide from a Sharing Your Wishes coalition in your community.

It is difficult to know what health care decisions will need to be made in the future, so the best way to plan is to choose an agent now to make decisions for you if one day you are unable to make them yourself. Your health care agent can talk to your doctor about your health condition and review your medical record to make decisions that he or she believes you would have made yourself. In New York State, if you do not select a health care agent and complete a Health Care Proxy form, your family will not be able to make health care decisions for you if you lose capacity. Your doctor will make emergency health care decisions and, if necessary, a court will make decisions for your care.
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A living will allows you to make decisions in advance and prepare written instructions about your health care if you become either terminally ill or have an irreversible condition and you are no longer able to speak for yourself. For example, you might use a living will to state specific treatments that you would want, and not want, if you are in a coma and there is no hope of your recovery. A living will is not a legally recognized document in New York State, but it can help your health care agent and caring professionals understand your wishes by providing clear and convincing evidence of the care you want, and don't want. A living will cannot be used to name someone (your health care agent) to make decisions for you.

You should understand that general instructions about refusing treatment, even if written down, might not be effective. Your instructions must be clear and understandable. For example, if you just write down that you do not want "heroic measures," this instruction may not be specific enough. Your instructions should be specific for medical conditions where recovery is not expected including coma, severe brain damage or terminal illness. The living will should say the kind of life-sustaining treatment that you want, or do not want, such as a respirator or chemotherapy. You can also give instructions orally by discussing your treatment wishes with your doctor, family members or others close to you. Putting things in writing is safer than simply speaking to people. But the best plan is to appoint a health care agent to decide for you if you are not able to make decisions yourself and to discuss your wishes with him or her.
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You may decide, after talking with your doctor, that you do not want emergency treatment to restart your heart and lungs if your heartbeat or your breathing stops. Your right to decide about treatment includes the right to decide about cardiopulmonary resuscitation (CPR).

A Do Not Resuscitate Order (DNR) lets you express your wish to avoid emergency treatment to restart your heart and lungs. A Do Not Resuscitate Order form [click to download] requires your doctor's signature and periodic review. If you do not have this form, emergency medical personnel (including doctors, nurses and ambulance paramedics) are required to attempt to restart your heart.

If you are in a hospital or nursing home, a hospital DNR form is used. If you are at home or in a hospice or medical clinic, you will need a Non-Hospital DNR Order. If your physical or mental condition prevents you from deciding about CPR, someone close to you - your health care agent or someone you appoint - your family members or close friend - can decide for you. This decision does not require a health care agent.
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The MOLST Program is designed to improve the quality of care people receive at the end of life. It is based on effective communication of patient wishes, documentation of medical orders on a brightly colored pink form and a promise by health care professionals to honor these wishes.

The MOLST form is a bright pink medical order form signed by a New York State licensed physician that communicates patient wishes regarding life-sustaining treatment to health care providers. These valid medical orders must be followed by all health care professionals in all sites of care, including the community.

The form includes medical orders and patient preferences regarding CPR (cardiopulmonary resuscitation), intubation and mechanical ventilation, artificial hydration and nutrition, antibiotics, and future hospitalization and transfer.

For further information and to see a sample MOLST form, view www.compassionandsupport.org.
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Important Information
Links to forms and information:
Health Care Proxy Form, NYS (PDF)
Living Will, NYS (PDF)
Do Not Resuscitate Order, NYS (PDF)
Understanding your health care choices
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