Advanced Directives

Last Modified: January 1, 2011


Dear OncoLink "Ask The Experts,"

What is an Advanced Directive and how can I make sure my wishes are known?


Tracy Lautenbach, MSW, LCSW, Social Worker in the Radiation Oncology Department at the Hospital of the University of Pennsylvania, responds:

An Advanced Directive is a legal document that allows you to state what type of medical care you wish to receive if you become unable to make such decisions or speak on your own behalf in the future.
There are two basic types of Advanced Directives: a Living Will and a Health Care Proxy.

A Living Will is a document in which you give specific instructions regarding your health care with particular focus on measures that relate to prolonging your life. It can describe what medical interventions you want to have done as well as what you do not want performed and under what specific circumstances. For instance: If your heart were to stop would you want CPR performed? Would you want to be on a respirator? If the medical issue was one of progressive disease and no treatments are available to help fight the cancer, you may not wish to have extraordinary measures taken such as resuscitation to prolong your life. In a situation like this, some people want to be explicit and request to sign a DNR order, also called "do not resuscitate", to ensure that none of these measures are taken.

Making these types of decisions is difficult and communicating them to your family can be an emotional challenge.

A Health Care Proxy is also referred to as a medical proxy, medical power of attorney or health care surrogate. This is the person who you have authorized to make health care decisions on your behalf when you are not able to do so yourself. This person can decide which medical interventions will or won';t be carried out. It is important when choosing this person that you chose someone who will make decisions based on what you want for yourself.

Make your family and friends aware of whom you have chosen as your health care proxy. Remember, you can change your proxy at any time as well as change your decisions as you need or want as well.

The following are two sites that offer low cost or free documents: