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Advance Directives

Advance directive is a general term that refers to your oral or written instructions about your future medical care, in the event that you become unable to communicate those instructions yourself.

Patient Self-Determination Act '90

The Patient Self-Determination Act of 1990 is Public Law 101-508, Section 4206 and 4751. It was enacted November 5, 1990, as part of OBRA '90, the Omnibus Budget Reconciliation Act of 1990.

Patient Self-Determination

This refers to the right of competent adults to make their own medical treatment decisions, and includes the right to complete advance directives, saying how and/or by whom decisions should be made in the future in the event the person becomes incapacitated and unable to make his or her own decisions.

Informed Consent

This is a legal term referring to the right to make medical treatment decisions. Under state law, it typically includes the right to be informed of one's medical condition and prognosis, the risks and benefits associated with a recommended procedure or course of treatment, and what alternatives exist. In the case of mental incapacity, an individuals right to give or withhold informed consent typically passes to the person's legal representative, usually an agent or attorney-in-fact under durable power of attorney, a court-appointed guardian, or close family member.

Advance Directives

A written statement of instruction in a form recognized by individual state law that addresses the provision of health care in the event of incapacity. Forms of advanced directive vary from state to state, but they typically include the living will, the durable power of attorney for health care and the Health Care Proxy.

Living Will

A document in which a person specifies the kind of life-saving and life-sustaining care and treatment he or she does or does not wish to receive in the event the person becomes both incapacitated and terminally ill. Many states have their own titles for a living will document such as "Directive to Physicians," "Declaration Concerning Health care," etc. Massachusetts law considers the document good evidence of patient wishes; however, it is not legally binding in Massachusetts.

Durable Power of Attorney for Health Care

This is a legal document through which a person appoints someone else, an "attorney-in-fact" or "agent," to act on the person's behalf in making medical treatment decisions in case of future incapacitation.

Health Care Proxy

A simple legal form that allows you to name someone of your choice to make health care decisions for you, according to your instructions, if for any reason you become unable to make or communicate those decisions yourself. A Health Care Proxy is now legally binding in Massachusetts.

Values History

The Values History Form, developed at the Center for Health Law and Ethics, University of New Mexico School of Law, recognizes that medical decisions we make for ourselves are based on those beliefs, preferences and values that matter most to us. A discussion of these and other values can provide important information for those who might in the future have to make medical decisions for that individual, when he or she is no longer able to do so. The Values History Form is not a legal document, although it may be used to supplement a Living Will or Durable Power of Attorney for Health Care.

Additional Advance Care Planning Resources

More information about advance care directives provided by the American Bar Association's Commission on Law and Aging can be found in their Consumer's Tool Kit for Health Care Advance Planning.

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