Advance Care Planning, Advance Directives & Medical Orders
Advance care planning (ACP) is the process of discussing and documenting your preferences for medical care.
Advance directives – such as health care proxy (HCP) forms or living wills – are documents that share your wishes for medical care in certain situations. They help guide discussions about what types of care you would or would not want if you were in those situations in the future.
Medical orders – including Medical Orders for Life-Sustaining Treatment (MOLST) forms and Do Not Resuscitate (DNR) orders – direct current medical care. They tell others what to do – or not do – for you if a medical emergency occurs now.
You may need to edit or update your advance directives and medical orders as your circumstances change. Be sure to review your advance directives regularly, as well as after major life events, such as births, marriages or divorces, and deaths. Learn more here.
Health Care Proxy Form
New York State Health Care Proxy Law allows you to appoint someone you trust – called a health care agent – to make decisions about your health care if you lose the ability to decide or communicate for yourself. Health care providers, including hospital staff, must follow your agent’s decisions as if they were your own.
You can give your agent as little or as much authority as you wish, and you can give them instructions. You can give your agent this role indefinitely until your death, or you can set a date or a condition for the role to end.
You can appoint a health care agent by signing a health care proxy form in the presence of two witnesses. You can also appoint alternate health care agents, in case your primary health care agent is unable or unwilling to act. Your agents must be at least 18 years old and must be willing to make choices according to your wishes and in your best interests. Your agent could be a family member, a friend, or another person you trust. Be sure that your agents are willing to serve, and be sure that you take time to discuss your wishes, beliefs, and values with them. Note that your agents cannot witness the form.
You can obtain a health care proxy form online or ask for one at your health care provider’s office or at the hospital.
A health care proxy form should be accessible in an emergency. Leave copies with your health care provider’s office, and bring copies to the hospital for any visit. Provide copies to your health care agents.
Learn more on the New York State Department of Health website.
If you are unable to make or communicate your own medical decisions and do not have a health care proxy form available, the New York State Family Health Care Decisions Act (FHCDA) uses a list to designate a family member or a close friend – called a surrogate decision-maker – to make decisions for you.
Living Will
A living will is a signed statement, made in advance, indicating your views and wishes about health care if you become unable to make or communicate your own medical decisions. The statement provides guidance to your health care agents and your health care team. A living will can express general views about your health care, or it can denote preferences about specific treatments (like cardiopulmonary resuscitation (CPR), ventilator use, feeding tube use, or blood transfusions) in specific situations.
Medical Orders for Life-Sustaining Treatment (MOLST) Form, including Do Not Resuscitate (DNR) Order
When considering their values and beliefs, some individuals may decide that they do not want to receive certain life-sustaining treatments. After discussing their medical conditions, the risks and benefits of these treatments, and their options with their health care team, a person may elect to ask a health care provider to write medical orders directing that specific interventions be withheld. These orders are documented on a Medical Orders for Life-Sustaining Treatment (MOLST) form. This form can be honored in all care settings, including the community.
A person may elect against receiving cardiopulmonary resuscitation (CPR) if their heart stops. After a discussion with a health care provider, a person may opt to instate a Do Not Resuscitate (DNR) order. Individuals with DNR orders still receive other types of care and will receive other appropriate treatments. A person can also decide against other treatments, like receiving the support of a ventilator or receiving artificial nutrition and hydration.
If a person has elected against receiving CPR or other life-sustaining treatments, the quality of the care they have opted to have is not compromised.
Learn more on the New York State Department of Health website.
Power of Attorney
A power of attorney (POA) is a legal document empowering another person – called an agent – to manage your financial affairs if you become unable to decide or communicate for yourself.
Learn more on the New York State Bar Association website. See the FAQs section for information about the authority of the agent.