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Posted by Positive Aging SourceBook on 05/26/2022

Understanding Advance Directives

Understanding Advance Directives

Protecting patient rights

An advance directive is a legal document that details medical and healthcare decisions that should be made on behalf of a patient if they are no longer able to make decisions. The document has two distinct parts. 

The first part, sometimes called a living will, ensures that patients receive only the life-prolonging treatments they select. Life-prolonging treatments are efforts that will not cure a terminal condition but will prolong dying. They include hydration (giving water) and nutrition (giving food) by tube, machines that breathe for you, and other kinds of medical and surgical treatment. 

Advance directives also allow patients to name an agent to act as their decision maker if they become incapacitated. This second part of an advance directive is often called a medical power of attorney or a durable power of attorney for health care. The person named to make decisions is a “health care agent.”

What happens if I cannot give my consent for treatment?

That is where an advance directive comes in. Adults can sign an advance directive to make their choices about medical treatments known in advance. If you become incapacitated, doctors or other caregivers can use this document to deliver only the medical treatments you want. Advance directives also give patients the option to appoint an agent to make decisions for them if needed. 

What happens if I cannot make decisions and I have no advance directive?

In Maryland, if you don’t have an advance directive—and later you can’t speak for yourself—usually your next of kin will make health care decisions for you. Even if you want your next of kin to make decisions for you, an advance directive can make things easier for your loved ones by helping to prevent misunderstandings or arguments about your care.

How do I select a health care agent?

A health care agent can be named in an advance directive. This person has the authority to see that doctors and other health care providers give you only the type of care you want. Before naming an agent, be sure to talk with the person and confirm they are willing to accept this responsibility.  

Do I need a lawyer to help me make an advance directive?

While you may want to consult an attorney, you do not need one to prepare either type of advance directive.

To make your advance directive valid, it must be signed by you in the presence of two witnesses, who will also sign. If you name a health care agent, make sure that person is not a witness. Maryland law does not require the document to be notarized. 

You should give a copy of your advance directive to your doctor, who will keep it in your medical file, and to others you trust to have it available when needed. 

How do I get advance directive forms?

To be valid in Maryland, your advance directive does not have to be on any particular form. Three example forms are highlighted below, but many more are available. Consumers should select one that meets their needs and reflects their values. 

• National Hospice and Palliative Care Organization (NHPCO) www.nhpco.org

• Aging with Dignity www.agingwithdignity.org

• Md. Office of the Attorney General www.marylandattorneygeneral.gov  

For additional information, visit www.marylandattorneygeneral.gov.


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