Advance directives and assisted suicide

What are Advance Directives?

The term “advance directive” may sound intimidating, but it signifies a simple yet important step in defining your future health care. Advance directives are legal forms that outline your wishes regarding medical treatments you may or may not want as you grow older or are in an accident and cannot speak for yourself. As part of completing these forms, you designate a decision-maker – called an agent – to carry out your wishes.

Advance directives should be completed when you are in good health, with a copy given to your agent, family members, lawyer and physician. The forms should be filled out in English so your doctors and health care facility can understand what you want. Advance directives also protect you from possible, future attempts to coerce you into participating in assisted suicide.

There are four types of advance directives in Illinois:

Power of Attorney for Health Care

In this document, you authorize a person – called your agent – to make health care decisions for you. Your documents can then guide your agent regarding general health care, as well as end-of-life decisions made on your behalf. The Power of Attorney for Health Care is the preferred advance directive to use.

Living Will

A Living Will is a witnessed, written statement of your decisions regarding death-delaying procedures if you have a terminal condition and are imminently dying. A Living Will speaks to a very narrow set of circumstances. It does not address the range of health care situations that can occur.

Illinois Practitioner Order for Life-Sustaining Treatment (Illinois POLST)

This document is a medical order that emergency personnel and other health-care providers generally follow regarding your treatment preferences. This includes preferences during a health crisis, such as a heart attack. A doctor or authorized health professional is needed to help with this form. This form is for seriously-ill individuals and is not for everyone.

Declaration for Mental Health Treatment

This form is for individuals who wish to make known their decisions or preferences relating to mental health treatment. It allows your agent to make limited mental health care decisions, among which could include short-term admission to a mental health facility for up to 17 days.

How Do I Pick An Agent for Advance Directives?

Your agent should be at least 18 years old and know you well. He or she does not have to be a family member. You should trust your agent to carry out your wishes even if he or she disagrees with them. Your agent should be willing to stand up for your decisions, and if your wishes are not clear regarding a specific situation, should be able to “stand in your shoes” and make reasonable determinations that reflect what you would want.

If you don’t pick an agent, your doctor, nurses and other health-care professionals will ask a court-appointed guardian, family members or close friends to make decisions for you. The Illinois Health Care Surrogate Act identifies people – or a group, such as all of your adult children – who will speak for you.

If you are alone and don’t have a person you trust to name as your agent, it’s important to talk to your doctor and other health care professionals about your wishes. Then write it down and make it part of your medical record.

Where Do I Get the Form for an Advance Directive?

The form for the Illinois Health Care Power of Attorney can be found on the website of the Illinois Department of Public Health at www.dph.illinois.gov.

If you are Catholic, the booklet “Encouraging End-of-Life Conversations: A Catholic Perspective on Advance Directives” offers guidance from a Catholic perspective. It also includes the form for the Illinois Health Care Power of Attorney with Catholic options included. You can download the booklet here.

Medicare Covers Advance Care Planning Conversations with Your Doctor

If you are 65 or older, Medicare fully covers a conversation with your doctor about advance care planning that takes place during your annual wellness visit. Advance care planning takes into consideration the information presented on this page – what health care you do or do not want if in the future you are unable to speak for yourself.

If you have a conversation with your physician about advance care planning that takes place separate from your annual wellness visit, the Medicare Part B deductible and coinsurance apply.