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Be specific about your final wishesBy J. KEITH FESTA Answer: Advance directives are instructions that will direct your doctor, hospital or other caregivers as to what kind of care you would like to receive in the event you become unable to express your desires concerning medical care in the future. An example of this is if you are in a coma and unable to respond to questions about treatment choices, the advance directives give guidelines as to what treatments you would like followed. They may cover what kinds of treatment you don't want, depending on how ill you are. They may also express under what conditions you may want treatments carried out to the fullest extent. Any advance directives must be made while you are well enough and mentally competent. A Do Not Resuscitate order — or DNR — is one type of advance directive. DNR would mean CPR would not be administered if your heart stops beating or you stop breathing. Many people who request DNR have severe advanced diseases such as cancer that has spread. Others may have organs or systems that have severely failed, like the kidneys, liver or heart. A health care proxy is also an advance directive. It is a person (or persons) you choose to make your health-care decisions if you are unable to do so. The person(s) should, of course, know your wishes very well and be someone you can trust to carry out your wishes as stated, despite any personal views they may hold. You can name more than one individual to make decisions jointly or you can name one primary person and backup individuals in the event that person cannot be located when needed. The choice is yours alone. A living will is another type of advance directive listing your wishes. It should be pretty explicit because the decision made on your health care will be based on what is written — especially if you have no health care proxy. A living will does not select someone to make the decisions for you. Often we only think about advance directives for the elderly or seriously ill people. However, one should consider them at other times. One of those important times is when your child turns 18 and is considered an adult. Unless they have a health care proxy made out in your name, you may not have the right to have a say in their health care in case of a medical emergency. Once your advance directives are made, you may cancel or change them at any time as long as you are considered of sound mind to do so. You should make your changes in writing, unless you don't have time to do so, and advise your family and physician of your changes. Bringing up the topic of advance directives is sometimes difficult. Usually, it is a little easier to begin discussions when people are in relatively good health, but many individuals still have difficulties. You and your physician can encourage the discussion with your family that will satisfy your wishes. (Note that all of these documents are available at http://www.PartingWishes.com, http://www.USLegalWills.com and http://www.LegalWills.ca).
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