All adults have a fundamental right to control their own medical care – including the right to consent to treatment and the right to refuse medical treatment. That right does not end simply because we become very ill or unable to speak for ourselves. Advance planning allows your wishes about health care to guide doctors, hospitals, and loved ones if you are ever unable to communicate those wishes directly.

Unfortunately, many patients lose the mental or physical capacity to make decisions or to clearly communicate their wishes. In those situations, family members and medical professionals can be placed in an extremely difficult position, left to guess what the patient “would have wanted.” Thoughtful planning, written down in advance, can spare your loved ones uncertainty and conflict at an already stressful time.

If you have strong feelings about life-sustaining treatment, pain control, artificial nutrition and hydration, or other aspects of end-of-life care, it is especially important to discuss those wishes with your physician and put them in writing. You should also talk openly with the person or people who may be asked to speak for you in the future.

If you have religious affiliations or moral convictions that are important to you, be sure to raise them with your health care providers and with your attorney. Many faith traditions have particular teachings about medical treatment and end-of-life decisions, and your planning can and should reflect those beliefs.

What Is an Advance Directive?

An Advance Directive for Health Care is a written statement that you make now, while you are able to decide for yourself, to guide your medical care in the future if you become unable to make your own decisions. New Jersey law recognizes two basic types of Advance Directives:

• An Instructive Directive (often called a “Living Will”), in which you write down your wishes regarding the medical care you do or do not want under certain circumstances.
• A Proxy Directive (also called a “Health Care Representative” or “Health Care Proxy”), in which you appoint someone you trust to make health care decisions on your behalf if you are unable to do so.

You may choose to complete one or both of these documents. Many people find it helpful to name a health care representative and also provide written instructions, so that the person they choose clearly understands their wishes and values.

Advance Health Care Directive / Living Will

A Living Will (Instructive Directive) allows you to state in writing what kind of medical care you would or would not want if you become permanently unconscious, terminally ill, or otherwise unable to communicate. You can address issues such as:

• Use of life-support machines (ventilators, respirators);
• Artificial nutrition and hydration (feeding tubes and IV fluids);
• Pain control and comfort measures;
• Any other treatments you feel are particularly important to accept or refuse.

Your Living Will serves as a guide to your doctors, your hospital, and your loved ones. While no document can anticipate every possible medical situation, a clear statement of your values and preferences can help those caring for you make decisions that honor your wishes.

Proxy Directive (Health Care Representative)

A Proxy Directive, sometimes called a Health Care Power of Attorney or Health Care Representative designation, allows you to name a trusted person to make medical decisions for you if you cannot speak for yourself. This person will work with your doctors and other health care providers to choose treatments consistent with your wishes and best interests.

The person you choose should be someone you trust, who understands your values, and who is able to handle difficult decisions under stress. You should talk with this person in advance about your feelings regarding serious illness, life support, and quality of life.

Should You Have an Advance Directive?

Only you can decide whether to sign an Advance Directive. However, many people find comfort in knowing that they have taken steps to guide their care and to ease the burden on their families. Without an Advance Directive, decisions may fall to relatives who may disagree with one another, or who may not be sure what you would have wanted.

An Advance Directive also allows you to express your wishes about organ donation and other important matters. If you do not wish to complete an Advance Directive, you should at least talk with your loved ones and your doctor about your preferences, so that they are not left completely without guidance.

Religious & Ethical Considerations

If your religious or moral beliefs play a central role in your life, it is important that your Advance Directive reflect those beliefs. Many faith communities have prepared guidance for their members on health care decisions and end-of-life care. You may wish to consult a member of the clergy or spiritual advisor in addition to your attorney and physician.

New Jersey Resources & Forms

The State of New Jersey maintains a comprehensive website with forms, information, and frequently asked questions about Advance Directives for Health Care:

https://www.nj.gov/health/advancedirective/ad/forums-faqs/

Here are direct links to the commonly used forms (developed by the New Jersey Commission on Legal and Ethical Problems in the Delivery of Health Care):

• Proxy Directive (Durable Power of Attorney for Health Care)  [pdf]
• Instructive Directive (Living Will)  [pdf]