Medical Directive Checklist
How it works
A medical directive (also called an advance directive or living will) documents a person's wishes regarding medical treatment if they become unable to communicate. The Medical Directive Checklist identifies key decisions to address and documents required by most healthcare facilities.
**Types of advance directives** Living Will: a written statement of your wishes for end-of-life medical treatment — specifically addressing circumstances where death is imminent. Healthcare Power of Attorney / Healthcare Proxy: designates a person to make medical decisions on your behalf when you are incapacitated (broader than a living will). POLST / MOLST: Physician Orders for Life-Sustaining Treatment — a medical order (not just a directive) signed by a physician that travels with you through the healthcare system. Do Not Resuscitate (DNR) Order: a specific medical order directed to healthcare providers.
**Decisions to address** Cardiopulmonary resuscitation (CPR): do you want CPR attempted in case of cardiac arrest? Mechanical ventilation (breathing machines): do you want ventilator support, and for how long? Artificial nutrition and hydration (feeding tubes): under what circumstances, if any? Dialysis. Antibiotics and other treatments with curative intent vs. comfort care only. Organ and tissue donation preferences. Preference for death at home vs. in a hospital vs. in hospice.
**Healthcare agent selection** Choose a person who: knows your values and can make decisions you would make; can handle conflict with medical professionals and family members; is available and willing to take on the role; is not intimidated by the medical system.
**Distribution** Provide copies to: your healthcare agent; your primary care physician; any hospitals or facilities where you receive regular care; family members who might be involved in your care. Keep original with estate planning documents.
This tool provides a checklist. Advance directives must comply with state law — have a licensed attorney or your state's statutory form used.
Frequently Asked Questions
- An advance directive is a legal document expressing your healthcare preferences if you become unable to communicate. Types: Living Will — specifies which life-sustaining treatments you want or don't want (ventilator, feeding tube, CPR, dialysis). Healthcare Power of Attorney — designates an agent to make medical decisions on your behalf. POLST/MOLST — physician-signed medical order for current, serious illness (more immediate than a living will). DNR order — specifically addresses resuscitation. Most estate planning attorneys recommend having both a living will and a healthcare POA.
- Requirements vary by state. Most states require either notarization or witnesses (typically two adults who are not healthcare providers, not related to you, and not named as beneficiaries in your will). Some states require both. Healthcare POAs specifically often require notarization. Store the original in an accessible place — not a safe deposit box. Give copies to your healthcare agent, primary care physician, and any specialists. Register with your state's advance directive registry if one exists. Ensure the document is in your medical record.
- An advance directive is a prospective document for future incapacity — you're competent now and planning for future scenarios. A DNR (Do Not Resuscitate) order is a current physician's medical order based on your current condition. DNRs are appropriate when CPR would not be medically beneficial or is contrary to your wishes given a current serious illness. For healthy adults doing estate planning, a living will that addresses CPR preferences is standard; a DNR becomes relevant when facing serious illness. Discuss both with your physician.
- Yes, at any time while you have mental capacity, regardless of your physical condition. Revocation can be oral (tell your doctor or agent), written (sign a revocation document), or by physically destroying the document. Inform all healthcare providers and your healthcare agent immediately when you revoke. Healthcare providers must follow your current wishes over an advance directive — a competent patient always has the right to refuse or accept treatment. Update your directive if your wishes change or if years pass and the document no longer reflects your current values.