Julie W. Childers, MD
Section of Palliative Care and Medical Ethics
University of Pittsburgh Medical Center
Email: childersjw2@upmc.edu
Office phone: 412-692-4834
Advance Care Planning is the process of making decisions now for what you would want in the future if you get sick. This could be after a stroke, a heart attack, an accident, or when you have cancer or other problems. In that situation, doctors can do a lot of things to keep a your body alive: they can use a machine to breathe for you, they can put a tube in your stomach and give food that way if you cannot eat, and if your kidneys stop working they can put you on dialysis to clean your blood. Even when a person’s heart stops and they die, they can give them shocks and do other things to try to make the heart start again. However, sometimes when a person is very sick those things don’t help them get better.
You can do some things now to tell the doctors what you want in the future. First, you can fill out a living will. This is different than the kind of will in which you say what you want to happen to your property after you die. These are your instructions how you want the doctors to treat you if you are very sick and there is no hope of recovery. You could say that you do not want a breathing tube, heart shocks, a feeding tube or other things, or you could say that you want some things but not other things. You could also say that you want the doctors to keep you alive no matter what. The doctors will only use these instructions if you are unconscious and they do not expect you to wake up.
Second, you can choose someone to make decisions for you if you are very sick and you can’t tell the doctors what you want. This is called a “health care agent” or “proxy”. This can be any adult family member or friend that you are close to. You should talk to that person about what you want and make sure he or she is willing to make those decisions for you. Then you should complete a form called a “Durable Power Attorney for Health Care” so everyone will know who that person is.
You do not need to go to a lawyer or pay any money to fill out these forms. They are available free.
Third, if you have cancer, serious heart or lung problems, or another major illness now you should talk to your doctor about whether medical treatments like a breathing machine or shocks to your heart would actually make you better. If the doctor thinks they probably wouldn’t work,
what do you want them to do in an emergency? That is your decision. If you do not want them, you can tell the doctors to only try to make you comfortable and peaceful when you are dying, not to try these things. This is called having a “DNR”, which stands for “Do Not Resuscitate”.
Talk to your doctor before making this decision.
For more information about advance care planning, visit the web site: Compassion and Support – End-of-Life and Palliative Care Planning
To download a free Pennsylvania Durable Power of Attorney for Health Care and a Living Will from the Allegheny County Medical Society and the Allegheny County Bar Association, go to:
Health Care Power of Attorney and Living Well (PDF file)