Your Right to Direct Your Future Health Care
How to let others know the care you want when you are
no longer able to express your wishes.
You have the right to make decisions about your health care. This includes the right to accept or refuse medical or surgical treatment. You also have the right to plan and direct the types of health care you may receive in the future if you become unable to express your wishes. You can do this by making an "Advance Directive."
What is an Advance Directive?
An Advance Directive tells, in writing, your choices about the treatments you want or do not want or about how health care decisions will be made for you if you become incapacitated and cannot express your wishes.
An Advance Directive expresses your personal wishes and is based upon your beliefs and values. When you make an Advance Directive, you will consider issues like dying, living as long as possible, being kept alive on machines, being independent and quality of life.
Who Can Make an Advance Directive?
If you are 18 years of age or older and of "sound mind," you can make an Advance Directive.
Why Should I Make an Advance Directive?
An Advance Directive speaks for you when you are unable to do so. Because it tells others the care and treatments you do or do not want and/or who will make healthcare decisions for you when you cannot express your wishes, it may relieve your family from the burden of guessing what you would want.
How Do I Make an Advance Directive?
There are two ways to make a formal Advance Directive. You can complete either a "Living Will" or a "Power of Attorney for Health Care" document. If you do not want to download these forms, they may be available from your health care provider or can be obtained from the Division of Health website or by calling (608) 266-1865. For a Wisconsin Do-It-Yourself Consumer Packet, Planning for Future Financial Decision-Making, you can visit the Coalition of Wisconsin Aging Groups website.
You do not need a lawyer to complete these forms. However, two persons must witness your signature to these forms. The forms themselves describe who may or may not be a witness.
You may also express your wishes using other forms and do not have to use these formal documents to make an advance directive.
What is a Living Will?
A Living Will informs your physician that you want to die naturally if you develop an illness or injury that cannot be cured. It tells your physician that, when you are near death or in a vegetative state, he or she should not use life-prolonging measures, which postpone, but do not prevent, death.
A Living Will allows you to refuse treatments or machines which keep your heart, lungs or kidneys functioning when they are unable to function on their own.
A Living Will goes into effect only when two physicians agree in writing that you are either near death and are unable to understand or express your health care choices, or are in a vegetative state that cannot be reversed.
What is a Power of Attorney for Health Care?
The Power of Attorney for Health Care is a form in which you appoint another person (a "health care agent") to make health care decisions for you if you are not capable of making them yourself. When you complete this form, you give authority to your health care agent to make a wide range of health care decisions for you, such as whether or not you should have an operation, receive certain medications, or be placed on life support. In some areas of health care, your health care agent is not allowed to make decisions for you unless you give him or her specific authority in these areas when you complete the form. These areas are listed on the form.
Because your health care agent will make decisions for you based upon what he or she knows about you and thinks is best for you, it is important to choose someone who knows you well and to discuss your treatment preferences with him or her. You can also include specific instructions about the type of treatments you want or do not want (such as surgery or tube feedings) when you complete the form.
A Power of Attorney for Health Care goes into effect only when two physicians, or a physician and a psychologist, agree in writing that you can no longer understand your treatment options or express your wishes to others.
What is the Difference Between a Living Will and a Power of Attorney?
A Living Will goes into effect only when your death is very near or when you are in a vegetative state and have no cognitive abilities. It deals only with the use or nonuse of life prolonging measures.
A Power of Attorney for Health Care also goes into effect when you can no longer make health care decisions but you do not have to be close to death or in a vegetative state. The Power of Attorney for Health Care allows another person to speak for you and make health care decisions for you that are not limited to just artificial life support. The type of decisions this person can make depends upon the extent of authority you give when you complete the form.
Should I Have Both a Living Will and a Power of Attorney for Health Care?
It is not necessary to have both a Living Will and a Power of Attorney for Health Care. If you do have both documents, you should make sure they do not conflict. If they do conflict, a health care provider will follow the instructions of a Power of Attorney for Health Care rather than instructions in the Living Will.
What if I Change My Mind?
You can cancel or replace a Living Will or a Power of Attorney for Health Care at any time. The different ways you can do this are explained on the forms you complete when you make a Living Will or appoint a Power of Attorney for Health Care.
Does My Health Care Provider Have to Follow My Advance Directives?
Some health care providers and physicians may have policies or beliefs, which prohibit them from honoring certain advance directives. It is important to discuss your Advance Directives with these people to make them aware of your wishes and to determine if they will honor your Advance Directive. If they will not, you may want to choose another health care provider.
What Happens if I Don't Make an Advance Directive?
You will receive medical care if you do not make an Advance Directive. However, there is a greater chance you will not receive the types of care and treatments you want if you have not made an Advance Directive.
If you cannot speak for yourself and have not made an Advance Directive, a physician will generally look to your family, friends or clergy for decisions about your care. If the physician or health care facility are unsure, or if your family is in disagreement about the decision, they may ask the courts to appoint a person (a guardian) who will make decisions for you.
Where Should I Keep My Advance Directives?
You should keep your Advance Directives in a safe place where you and others can easily find it. (Do not keep it in a safe deposit box.) You should make sure your family members and your lawyer, if you have one, know you have made up an Advance Directive and know where it is located. You should also ask your physician to make your Advance Directive part of your permanent medical record.
I Have Some Questions, Who Can Answer These or Give Me Additional Help?
Your physician or other health care providers can help you understand your health needs and the options for treating these needs. They can answer questions about Advance Directives.
You can also contact your lawyer or the following agencies if you have questions about Advance Directives:
Wisconsin Division of Health
Center for Public Representation
Coalition of Wisconsin Aging Groups
Center for the Study of Bioethics/Medical College of Wisconsin
Wisconsin Board on Aging and Long Term Care (Ombudsman Program)
This information has been developed by the Department of Health and Social Services, Division of Health, with assistance by and in cooperation with:
- Association of Wisconsin Health Maintenance Organizations
- Catholic Health Association of Wisconsin
- Center for Public Representation
- Center for the Study of Bioethics/Medical College of Wisconsin
- Coalition of Wisconsin Aging Groups
- Hospice Organization of Wisconsin
- State Medical Society
- Wisconsin Association of County Homes
- Wisconsin Association of Homes and Services for the Aging
- Wisconsin Association of Medical Directors
- Wisconsin Board on Aging and Long Term Care
- Wisconsin Homecare Association
- Wisconsin Hospital Association
Prepared under the guidance of the:
Department of Health and Family Services
Bureau of Quality Assurance
2917 International Lane, Suite 300
Madison, WI 53704
Click here to learn more about 5 Wishes.
If you are a Wisconsin resident and choose to use the 5 Wishes Document to express your medical, personal, spiritual and emotional needs, you will need to attach the notice statement to your 5 Wishes document in order to make it a valid legal document.