End of Life - Advance Health Care Directive

The laws governing Minnesota allow persons age 18 or older the right to state their wishes or appoint an spokesperson in the form of an Advance Health Care Directive. Since 1998, the term describes a document that combines the powers of a Living Will and Health Care Power of Attorney into one directive.

An Advance Health Care Directive legally documents an individual’s wishes about the future. It gives persons a measure of control over any medical treatment they will receive in the future by providing clear instructions to physicians and family members in case they can no longer communicate. By planning ahead of time about death, Advance Care Directives help ease the burden of responsibility and make things easier for loved ones.

A person has many choices of what to include in a health care directive, including:

A trusted person (agent) who will make health care decisions for the individual, as well as joint or alternative persons. The directive can also state how the agent should make decisions.
Health care goals, values and preferences. These can be general or very specific.
The types of medical treatment desired or unwanted, and instructions about nutrition and hydration.
Preferred place for care to be received.
Organs, tissue and eyes donation prefereences.
Funeral arrangements.

However, according to the Minnesota Department of Healthviii, a health care directive must meet the following requirements to be legal:

Be in writing and dated.
State your name.
Be signed by you or someone you authorize to sign for you, when you can understand and communicate your health care wishes.
Have your signature verified by a notary public or two witnesses.
Include the appointment of an agent to make health care decisions for you and/or instructions about the health care choices you wish to make.
Health care directives prepared in other states are legal if they meet the requirements of the other state's laws or the Minnesota requirements. It is important to note that medical providers will not comply with requests that fall outside of accepted medical practices, even if they are stated in the directive.

There are important legal issues to keep in mindix. For instance, a properly written health care directive is legally binding until the individual changes or cancels it. Before August 1, 1998, Minnesota law provided for several other types of directives, including living wills, durable health care powers of attorney and mental health declarations. Then, the law changed so people could use one form for all their health care instructions. Forms created before August 1, 1998, are still legal if they followed the law in effect when written. They are also legal if they meet the requirements of the new law (described above). It is important to review any existing documents to make sure they are still accurate and meet the legal requirements.

After completing and signing a Health Care Directive, the individual should inform important people such as family members, the agent listed, and health care providers, and give them a copy. In addition, they should keep it in a safe place where it can be easily found. NOTE – Many people put their directive in their safety deposit box. This is often not a good place, because loved ones may not have access to the box.

Additional information and Directives approved in Minnesota are available from many sources, such as health care providers, health care insurers, and attorneys. Samples include:

The Minnesota Department of Health recommends a suggested Health Care Directive form that is available on the Minnesota Board on Aging Web site, http://www.mnaging.org.
Valid in Minnesota, Five Wishes is a unique Directive that looks to all of a person's needs, including medical, personal, emotional and spiritual. It puts into place not only the person who will make decisions and the kind of medical treatment preferred, but also: How comfortable a person wants to be, how an individual wants to be treated by others, and what the person wants loved ones to know. Five Wishes was developed by a grant through The Robert Wood Johnson Foundation, the nation's largest philanthropy devoted exclusively to health and health care, and is available at http://www.agingwithdignity.org/5wishes.html