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Short Summary
Main recommendation: Complete an advance directive, a legal document that names who should make medical decisions for you if you cannot and records the treatments you would or would not want. Dr. Neil Wanger, a primary care doctor who works with the UCLA Health Ethics Center, presents it as a way to plan ahead and share those choices with loved ones and your doctor before an emergency happens.
Key Points
- An advance directive covers two things: who speaks for you if you can't decide, and what care you would want or refuse in certain health states.
- Doctors and patients ideally make decisions together, but sudden severe illness or injury can make that impossible, so decisions may fall to someone else.
- Without a written document, doctors may not know to turn to a friend or non-spouse, so naming a decision maker in writing matters.
- You can name a second and third person as backups if the first cannot serve.
- Wanger notes that people with no medical problems are often the ones he asks to consider this, using a serious car accident as the example.
- Clear written decisions make things easier for the family who would otherwise have to guess.
Details Worth Noting
- Concrete instructions: Write down who you want to make decisions for you, then name a second and third person as backups. Record the kinds of treatments you would want and the health states in which you would not want doctors and hospitals to keep you alive. Discuss these choices with the people you name and, ideally, with your doctor. At your next doctor visit, say something like, "Hey Doc, during the visit today, how about if we do advance care planning?"
- Wanger frames the planning as something to do even when you do not feel like thinking about it, since the scenarios are uncomfortable but possible.
- He uses a sudden accident example, asking whether you would want doctors to keep you alive if you were not going to wake up or return to your current way of living.
- The transcript does not name a specific form, state law, or legal requirement; it describes the document only in general terms.
Bottom Line
Planning ahead in writing protects both your wishes and your family from having to guess during a crisis, and the conversation with your doctor is a practical place to start.
