Health Care Directives
A health care directive allows you, as a patient, to express your wishes regarding what kinds of health care and treatment you wish to receive, in the event that you can¹t tell them yourself because of illness or injury. It also lets you say how much care and treatment you want. In addition, a directive enables you to name someone that you trust — known as your “agent” — to speak on your behalf, and make to decisions on your health care, in the event that you are not able to. It replaces both a living will and durable power of attorney for health care.
A social worker or chaplain can help you create your Health Care Directive. (Minnesota and Wisconsin have different forms to complete.) St. Mary’s Medical Center also regularly sponsors a free talk called “Health Care Directives: Why Plan Ahead?” where you can find out more details about what a Health Care Directive does and how to complete one.
More About Health Care Directives (including how to prepare one)
Please note that the information below does not give every detail of the law. Ask your attorney if you have legal questions.
What is a health care directive?
A health care directive is a legal written document that tells others your wishes about your health care. A health care directive may also be called a living will, a durable power of attorney for health care, or something else depending upon where you live. It allows you to name one or more persons to serve as your agent(s). The job of your agent(s) is to carry out your wishes and/or to make decisions for you. You must be at least 18 years old to make a health care directive.
Why have a health care directive?
A health care directive is important if you can¹t communicate your health care choices because of physical or mental incapacity. It is also important if you want someone else to make your health care decisions for you.
How do I make a health care directive?
You can get forms for health care directives from your doctor, attorney, the Minnesota Board on Aging (1-800-882-6262 or 651-296-2770), or the State of Wisconsin, Division of Public Health (608-266-1251). You don¹t have to use a form, but your health care directive must meet the following requirements to be legal:
- It must be in writing and dated
- It must state your name
- It must be signed, either by you or by someone you authorize to sign for
you while you are able to understand and communicate your health care
wishes
- A notary public or two witnesses must verify your signature
- You must appoint an agent to make health care decisions for you and/or
leave instructions about the health care you want
Before you prepare or revise your health care directive, you should discuss
your health care wishes with your loved ones and your doctor or other health
care provider. In most cases your doctor cannot be your agent.
What information can I include in my health care directive?
You may choose to include:
- The person(s) you trust to be your agent(s). You may also name
alternate(s) in case your agent is not available
- How you want your agent to go about making decisions for you
- Your goals, values and preferences
- Where you want to receive your care
- What types of medical treatment you would want or not want. (Examples may
be artificial feeding and hydration, mental health treatments that use
electroshock therapy or neuroleptic medications.)
- What treatments you would want for your baby and yourself if you were
pregnant
- If you want to donate your organs, tissues or eyes
- Whom you would like as your guardian or conservator if there were a court
action
You may be as specific or as general as you wish. You can choose which
issues or treatments to deal with in your health care directive.
Are there any limits to what I can put in my health care directive?
There are some limits about what you can put in your health care directive. For example:
- Your agent must be at least 18 years of age
- You cannot request health care treatment that is outside of reasonable
medical practice
- You cannot request healthcare treatment that is against the law,
such as assisted suicide
Must I have a health care directive?
You don¹t need to have a health care directive. You will still receive medical treatment if you don¹t have a written health care directive. Health care providers will listen to what people close to you say your wishes would be. However, the best way to be sure your wishes are followed is to have a health care directive.
If you do have a health care directive, hospitals within the SMDC Health System, both religious and secular, will honor your wishes as long as they comply with state law.
How long will my health care directive last? Can I change it?
Your health care directive lasts until you change or cancel it. As long as the changes meet the requirements listed above, you may change it at any time. You may cancel your health care directive by:
- Writing a statement that you want to cancel your health care directive
- Destroying it
- Telling at least two other people you want to cancel it
- Writing a new health care directive
Tell your doctor and/or hospital if you change or cancel your health care directives.
What if I already made a different type of health care document? Is it still good?
Before August 1, 1998, Minnesota law allowed several other types of health care directives including living wills, durable health care powers of attorney and mental health declarations. The law changed so people can use one form for all their health care instructions. Forms created before August 1, 1998, are still legal if they follow the law in effect when they were written. They are also legal if they meet the requirements of the new law (described above). You may want to review any existing documents to make sure they say what you want and meet all the requirements.
I prepared my health care directive in another state. Is it still good?
Health care directives from other states are legal in Minnesota if they meet both Minnesota requirements and the requirements of the other state¹s laws. If you live in Wisconsin it¹s a good idea to use the form approved in Wisconsin because the types of decisions that your agent can make are regulated by Wisconin law. Your wishes will be followed in Minnesota hospitals.
What if my health care provider refuses to follow my health care directive?
Your health care provider must follow your health care directive or any instructions from your agent, as long as the health care directive follows reasonable medical practice. You or your agent cannot request treatment that won¹t help you or which the provider cannot provide. If the provider cannot follow your agent¹s directions about life-sustaining treatment, the provider must inform your agent. The provider must also document the notice in your medical record. Those providing your care must allow your agent to transfer you to another provider who will follow your agent¹s directions.
All hospitals within the SMDC Health System have access to an ethics committee. Each ethical question that may arise concerning various treatment options may be first explored with the physician involved with the case, and, if necessary, taken to the ethics committee. This may be done by staff, providers, patients or their families by speaking to the appropriate manager.
What should I do with my health care directive after I have signed it?
Keep it in a safe place where it can be easily found. Tell family members, your health care agent(s), and your health care providers that you have a health care directive. It is a good idea to give a copy to your doctor, the hospital where you receive care, your agent(s), and other family members. Review and update your health care directive as your needs change.
For more information:
If you would like more information, contact your health care provider; your attorney, the St. Mary's Medical Center Chaplaincy department (218-786-4442); the Office of the Ombudsman for Older Minnesotans (1-800-657-3591 or 651-296-0382); the University of Minnesota Extension Service (1-800-876-8636 or 612-624-4900 or email: order@dc.extension.umn.edu).; or the Coalition of Wisconsin Aging Groups (1-800-366-2990 or email: www.cwag.org).
SMDC Health System regularly offers free classes for members of the community to learn more about health care directives. See the box in the upper right of this page for times, dates and lcations of classes.