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Advance directive is a general term that refers to your oral and written instructions about your future medical care, in the event you become unable to speak for yourself. Each state regulates the use of advance directive differently. In Maryland, The Healthcare Decisions Act was adopted in 1993 and recognizes two types of advance directives: a Living Will and a medical power of attorney titled Advance Directive. Both documents require the signature of two witnesses.
A living will is a shorter type of advance directive in which you put your wishes in writing. You state the level of medical treatment you want provided should you be unable to communicate at the end of life. Maryland state law defines when the living will goes into effect, and limits the treatments to which the living will applies. Your right to accept or refuse treatment is protected by constitutional and common law.
A medical power of attorney is a document that enables you to appoint someone you trust to make decisions about your medical care if you cannot make those decisions yourself. This type of advance directive is sometimes referred to as a “health care proxy” or “appointment of a health care agent.” The person you appoint may be called you health care agent, surrogate, attorney-in-fact, or proxy. In many states, the person you appoint through a medical power of attorney is authorized to speak for you any time you are unable to make your own medical decisions, not only at the end of life. You are free to change or revoke an advance directive at any time.
Advance directives give you a voice in decisions about your medical care when you are unconscious or too ill to communicate. As long as you are able to express your own decisions, your advance directive will not be used, and you can accept or refuse any medical treatment. But if you become seriously ill, you may lose the ability to participate in decisions about your own treatment.
Both federal and state laws govern the use of advance directives. The federal law, the Patient Self-determination Act, requires health care facilities that receive Medicaid and Medicare funds to inform patients of their rights to execute advance directives. All 50 states and the District of Columbia have laws recognizing the use of advance directives. The booklet, “Advance Directives, A Guide to Maryland Law on Health Care Decisions” available from the Office of the Attorney General, 200 St. Paul Place, Baltimore, MD 21202-2021, offers more complete information about an advance directive. The information and forms are also available on line.
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