Advance Health Care Directives

As part of an estate planning package, most attorneys prepare advance health care directives or Living Wills along with a Last Will and Testament or Revocable Trust.  An advance directive is a document in which you give directions for your health care at some time in the future when you may be unable to make health care decisions or speak for yourself.

In Tennessee, the two most commonly used advance health care directives are the Living Will and the Advance Care Plan.  Both documents are valid under state law.  The Tennessee Living Will was developed in 1985.  The Tennessee Advance Care Plan was developed in 2004.  The Advance Care Plan can be found on the Tennessee Health Department website at http://health.state.tn.us/AdvanceDirectives/Advance_Care_Plan.pdf. 

There are differences between the two documents. The Living Will addresses the circumstance where the signer, called the “declarant,” is terminally ill, with no hope of recovery, and is unable to speak for themselves.  In the Living Will, the declarant expresses his or her wishes about whether artificially-provided food and fluids (such as a feeding tube and intravenous fluids) can be withheld or withdrawn if the person is in a terminal condition. 

In contrast, the Advance Care Plan gives the declarant a way to state their wishes about a wider range of possible physical conditions and a wider array of possible treatments.  In the Advance Care Plan, the declarant can indicate their wishes regarding cardio-pulmonary resuscitation, maintenance on life support such as ventilators, or treatment for new conditions, as well as the administration of artificially provided food and fluids.  The declarant can indicate if there are other conditions (including being permanently unconscious, permanently confused or permanently dependent in all activities of daily living) that they may find to be unacceptable.

Whether you choose to sign the Living Will or the Advance Care Plan, think it through carefully and once you have signed it, talk to your family and friends , especially those who will be making the health care decisions for you.  Let your doctor know and make a copy of the form for your doctor’s file.  You can always revoke the directive if you change your mind later.