November 08, 2023
Health Care Decision-Making
If you are looking at this web page, you are either thinking of making a health care advance directive (such as a living will or durable power of attorney for health care), or you may have already signed one. In either case, you should be aware that just having a written advance directive by itself does not ensure that your wishes will be understood and respected. Studies have shown that standard advance directive forms do little to influence end-of-life decisions without: (1) informed, thoughtful reflection about your wishes and values, and (2) personal communication between you and your likely decision-makers before a crisis occurs.
Why a Tool Kit?
Good advance planning for health care decisions is, in reality, a continuing conversation--about values, priorities, the meaning of one's life, and quality of life. To help you in this process, this tool kit contains a variety of self-help worksheets, suggestions, and resources. There are currently 8 tools in all, each clearly labeled and user-friendly. The Tool Kit does not create a formal advance directive for you. Instead, it helps you do the much harder job of discovering, clarifying, and communicating what is important to you in the face of serious illness. Download below.
Tool Kit for Health Care Advance Planning helps you clarify your values, priorities, and wishes regarding your future health care.
More Health Care Advance Planning Tools
Free resources to walk you and your loved ones through the steps of health care advance planning.
- Links to Free State-Specific Advance Planning Forms
- How to Make Decisions for Someone Else is a guide for your proxy, explaining the job description of a proxy and tips for making good decisions.
More Consumer Information
Health Care Planning Guides and Tools
Pathways to Health Care Decision Making - Factsheet detailing the six preferred ways to make healthcare choices.
Sample HIPAA Right of Access Form for Family Member/Friends
This form allows you to direct health care providers and payers to disclose and release protected health information to whomever you name.
Health and Financial Decisions: Legal Tools for Preserving Personal Autonomy
Information on powers of attorney, trusts, health care advance directives, living wills and other planning tools. 2005.
- PDF download
- Spanish Version: Decisiones de Salud y Monetarias (Financieras): Recursos Legales Para Mantener Sus Propios Deseos e Intereses Personals." PDF download
Myths and Facts About Health Care Advance Directives
by Charlie Sabatino, Bifocal, Vol. 37, No. 1 - September 2015
Lawyer Resources
Advance Directives: Counseling Guide for Lawyers is designed to assist lawyers and health care professionals in formulating end-of-life health decision plans that are clearly written and effective. Click the link above for the FREE PFD download of the entire book or key sections of the Guide.
Third-party Resources
- National POLST POLST is the national term referring to portable medical orders intended for patients who are considered to be at risk for a life-threatening clinical event because they have a serious life-limiting medical condition, which may include advanced frailty. POLST has different names in different states but is simply called POLST at the national level. National POLST is a collaborative of state POLST programs that has set voluntary standards and policies for the adoption and implementation of POLST by states.
- American Bar Association and Harris Interactive Inc. 2008 Healthcare Emergency Planning Poll
Legislative Analysis
Oral Designation of Health Decisions Surrogate Recognized by Statute (Aug. 2020)
Default Surrogate Consent Statutes (Oct. 2022)
State Health Care Power of Attorney Statutes: Selected Characteristics (January 2022)
Orally Provided Food and Fluids and Comfort Care (July 2017)
Health Care Decision-Making: A Guardian's Authority
- Health Care Decision-Making Authority: Who Makes the Decision? (50-state chart) (July 2015)
- Health Care Decision-Making Authority: What is the Decision-Making Standard?(July 2015)
Annual Summaries
Research
Incapacitated and Alone: Health Care Decision-Making for the Unbefriended Elderly
This 2003 publication is now available as a free pdf download. It presents the findings of a ground-breaking study aimed at improving medical decision-making on behalf of older patients incapable of making their own decisions and lacking surrogate decision-makers.
Health Care Decision-Making in Clinical Settings
This research project launches a major study of how health care providers make health care decisions for patients in a clinical setting who lack capacity and have nothing in writing naming a person to make health care decisions. The research is made possible by funding from the Retirement Research Foundation. Joining the Commission in undertaking this research are the Society for Hospital Medicine and the Society for Critical Care Medicine.
- Health Care Decision Making in Clinical Care Settings
Report, research, findings and recommendations.
Information for Physicians
- POLST: The Seven Deadly Sins - This article appearing in Bifocal Vol. 39, Issue 4 discusses the missteps that undermine a patients’ informed decision-making and why health care providers should be aware of and conscientiously avoid the seven deadly sins of POLST. (April 2018)
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