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Advance Directives for Health Care

By Asha F. Jackson
June 28, 2007

With the Advent of the Federal Patient Self-Determination Act of 1990, all states receiving funding for medical assistance are required to provide patients with an option to have an Advanced Directive for Health Care. 42 U.S.C. '1395 cc (a). Following the passage of this Act, states have recognized that competent individuals have the right to convey their health care preferences in the event that they develop a terminal illness or life-threatening condition. The document has been commonly referred to as a living will or an advance directive for health care.

Many states also recognize the concept of a health-care guardian, or medical power of attorney, which allows an individual to appoint a person to make medical decisions on their behalf in the event that they are unable to do so. The requirements for executing a living will, executing an advanced directive for health care decisions, appointing a guardian or creating a medical power of attorney vary from state to state, but the purpose of these documents and information contained therein has been fairly consistent.

These documents, which shall be referred to as advance directives, contain personal decisions that let family and friends know a person's specific health-care preferences, including directing the withholding or withdrawal of life-sustaining procedures when that individual is in a terminal condition, coma, or persistent vegetative state. For consistency and to encourage widespread use, many states have begun to combine the concepts of a living will and a health care power of attorney, replacing them with the creation of one form called an advance directive that will contain all of the concepts in one document. See, e.g., N.J.S.A. 26:2H-54; 30 Cal. law Revision Comm. Rep (2000); 2007 Georgia Laws Act 48 (H.B. 24) O.C.G.A. '31-32-1

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